Are Youngsters really having more Heart Attacks?

A look at some data from Scotland

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Photo by Michel E on Unsplash

We have all read the stories of athletes having heart problems and healthy youngsters dying suddenly but are these cases just being reported more and everybody on the lookout for another young death? Maybe these events happened just as frequently in recent years and we just didn’t pay attention?

The short answer to the question in the title of this post is yes, youngsters are having more heart attacks, in Scotland anyway.

Public Health Scotland provides a handy little dashboard to keep track of these events.

When comparing weekly cardiovascular cases in out of hours services between 2020 and 2021, compared with the 2018-2019 average (in all ages) we get this graph.

The green dashed line is the 2018-2019 average and the solid black line is 2020-2022. As you can see, other than around the first lockdown (March 2020), the number of cases was almost identical to the average during the pandemic. That was until June 2021, when the numbers began to diverge.

What caused this divergence in June 2021 and what has caused it to continue rising? In June 2021 the difference was approximately 10% higher than average which rose quickly to 30-40% higher. By December 2021 the number of cases was over 55% higher than average and the last date recorded in February was still approximately 50% higher.

However, not all age groups contribute to the increase in cases. Most age groups have been relatively stable the whole time with only the youngest (15-44) showing a substantial increase.

So as not to produce lots of graphs I have combined the 45-64, 65-74, 75-84 and 85 and over age groups in one set of graphs.

The graph on the left is the percentage change in cardiovascular cases and the graph on the right number of cases. As you can see, this has been relatively steady, both in numbers and when compared with the 2018-2019 average.

Now look at the graphs for 15-44 year olds. Firstly, cases.

There was a big jump during lockdown and then it was relatively flat until June 2021. Since then it has been steadily climbing, with no sign of stopping.

Again, looking at the percentage change versus 2018-2019, there was a big jump during lockdown and it stayed consistently higher throughout the pandemic. However, in June 2021 there was a big jump (117% increase) and the trend shifted from flat to steadily rising. The last reading, in February 2022, showed a 86.7% increase versus the average.

Is there any difference in men versus women?

Women saw a big jump in June 2021 but, whilst the difference has remained consistently high, the trend seems to be on a downward slope.

The story is a different one for men. The big jump occurred ever so slightly later in July 2021 but this time the trend is still very much up.

So, there has been a significant increase in cardiovascular cases since 2021, primarily in 15-44 year olds and this doesn’t seem to be changing. What changed in June 2021 that could have caused this jump?

The first thing that may have caused the increase is delayed effects from lockdowns. Delayed care, a reduction in exercise, anxiety and stress are a number of factors that could have had delayed effects. However, lockdowns hit the poorest the hardest so maybe this would show up in the data?

Comparing the most deprived (blue line) versus the least deprived (green line) we see that the change for the most deprived has been relatively steady throughout. However, the least deprived saw the big jump mid 2021 and has been on an upward trend since.

The other factors that could have caused the increases are Covid and vaccines. If it was Covid then why did the big increases not happen until 2021? Delayed effects or a new variant? If that was the case then why did it not affect other age groups? Most people in the 15-44 age group (especially the older end of that group) would have had their first dose by June 2021 and would have been moving on to their second. The only logical conclusion is that vaccines caused the change in trend unless anyone has any other ideas?