Heart Attack Myth #1 – I’m Too Young for a Heart Attack.

Heart Disease affects people of all ages. Men and Women as young as 20 have had heart attacks. Just because you are young doesn’t mean you are not at risk.

Heart attacks kill over 150,000 people in the USA each year.  More than 700,000 will experience a first heart attack.

Even though the average age of heart attack sufferers is 65 for men and 70 for women, this average is taken from samples of heart attack victims which range in age from their teens to their 90’s.

A recent Harvard Health Study found that 10% of heart attacks occur before the age of 45.  80% of these heart attacks are caused by CAD – Atherosclerotic blockages in coronary arteries.  The 0ther 20% can be attributed to various blood clotting disorders and congenital/structural defects of the heart.

Of the 80% who suffer heart attacks caused by CAD; 60% of these patients have blockages/disease in just ONE artery.

Another study of sudden deaths of men and women between the ages of 18 and 35 showed that half of these deaths were caused by various forms of heart disease.

Numerous studies indicate that CAD is established in childhood and teenage years and continues to worsen into adulthood.

The risk for life threatening or life ending heart attacks in men increase after age 45.  These risks for women increase after age 55.

In most cases treatment for high blood cholesterol and other heart disease risk factors could have prevented patient’s initial risk for heart attacks.

If any member of your direct family (those related to you by blood such as your mother or father or their parents) has died from or has been diagnosed with CAD – you need to discuss your potential for a higher than normal risk of CAD for yourself with a qualified health care professional.


Cycling 20 Minutes Each Day Can Reduce Your Risk of CAD and Cancer by 50%

The World Health Organization (WHO) has established minimum guidelines for exercise which has been shown to reduce your risk for heart disease and cancer. These guidelines state that adults aged 18–64 should do at least 150 minutes of moderate-intensity aerobic physical activity throughout the week or do at least 75 minutes of vigorous-intensity aerobic physical activity throughout the week or an equivalent combination of moderate – and vigorous-intensity activity.

The study published in Medicine & Science in Sports & Exercise looked at the activity levels and heart health of more than 1,500 men and women ages 37 to 55 over a five-year span. Those who racked up the highest amount of short-bout activity (the average was 28 minutes) on a daily basis were 31 percent less likely to develop high blood pressure than those who accumulated the least. Each 10-minute increase in short-bout activity dropped the subjects’ risk 9 percent.

Similarly, the Copenhagen Heart Study, which monitored over 5000 people over a period of 14 years, found a major association between high intensity cycling and reduced risk of coronary heart disease death.

Key Indicators in the Development of CAD (Coronary Artery Disease)

The number 1 indicator for if you are at high risk for CAD is your family history and any genetic predisposition you may have been born with.

The number 1 indicator for if you are at high risk for CAD is your family history and any genetic predisposition you may have been born with.

“Coronary artery disease begins in childhood, so that by the teenage years, there is evidence that plaques that will stay with us for life are formed in most people. Preventive measures instituted early are thought to have greater lifetime benefits. Healthy lifestyles will delay the progression of CAD, and there is hope that CAD can be regressed before it causes heart disease.”

Edward A. Fisher, M.D., Ph.D., M.P.H.,
Leon H. Charney Professor of Cardiovascular Medicine
Marc and Ruti Bell Vascular Biology and Disease Program – NYU School of Medicine

Some of my earliest memories were of attending my grandfather’s funeral (heart attack) and my grandmother’s bypass surgery and her death shortly after. One by one my uncles passed away from CAD and heart attacks that they didn’t survive. The link between untimely death (death below age that is the national average) and heart disease in my family is undeniable.

Once you’ve established that CAD is something that runs in your family or not (in my case it’s an all caps “YES”), the following list of indicators all represent lifestyle and diet choices you can make that will greatly increase your risk of developing CAD.

Risk factors for the development of CAD:

Conventional risk factors:

  • Age: Over age 45 years in men and over age 55 years in women – plaques build up over time; the older you get the more likely that stenosis can and will develop
  • Family History: Likelihood of increased risk with positive family history is significant due to a number of genes now identified that are linked to CAD and are known to be hereditary
  • Race: Among persons with CAD, the cardiovascular death rate for African Americans is reported to be particularly high; in Asians, low levels of high-density lipoprotein cholesterol (HDL-C), which are considered to be a risk factor for coronary heart disease, appear to be especially prevalent; South Asians appear to have a higher independent risk for cardiovascular disease as well.

Modifiable risk factors:

  • High blood cholesterol levels (specifically, low-density lipoprotein cholesterol [LDL-C])
  • High blood pressure
  • Cigarette smoking: Cessation of cigarette smoking constitutes the single most important preventive measure for CAD
  • Diabetes mellitus
  • Obesity
  • Lack of physical activity
  • Metabolic syndrome
  • Mental stress and depression

Nontraditional or novel risk factors: High levels of the following are considered to be risk factors for CAD:

  • C-reactive protein (CRP): High levels are related to the presence of inflammation and, according to some research results, may be associated with an increased risk of CAD development and heart attack
  • Lipoprotein(a)
  • Homocysteine: In the general population, mild to moderate elevations are due to insufficient dietary intake of folic acid, but homocysteine levels may also identify people at increased risk for heart disease
  • Small, dense LDL-C particles – In some people LDL-C particles are more dense than in the general population; these smaller particles allow for plaque build-up and stenosis
  • Fibrinogen: a blood plasma glycoprotein that is important in the formation of blood clots; higher levels of fibrinogen are associated with CAD; it is unknown if this is a reaction to stenosis or yet another variable that indicates a trigger for the clotting mechanisms that are typically associated with heart attacks (MI).

Various medical conditions that can contribute to CAD include the following:

  • End-stage renal disease (ESRD)
  • Chronic inflammatory diseases affecting connective tissues (eg, lupus, rheumatoid arthritis)
  • Human immunodeficiency virus (HIV) infection (acquired immunodeficiency syndrome [AIDS], highly active antiretroviral therapy [HAART])
  • Xanthelasmata (raised yellow patches around the eyelids)

The following are also considered to be risk factors:

  • Tissue plasminogen activator (tPA): An imbalance of the clot dissolving enzymes (eg, tPA) and their respective inhibitors (plasminogen activator inhibitor-1 [PAI-1]) may predispose individuals to myocardial infarctions
  • Low serum testosterone levels: Have a significant negative impact on patients with CAD
  • Hysterectomy: A study suggests that this becomes a risk factor later in life in women who have the surgery at or before age 50 years
  • Lack of sleep

When looking at the exhaustive list of contributing factors above remember that just because you have family history and you are overweight it doesn’t mean that you are going to develop CAD. It simply means that you are at greater risk.

When looking at the indicators above it becomes clear that there are two types of risk factors: those that are beyond your control such as family history, age, race, sex, and any hereditary/genetic traits you may have inherited, and there are those that are in your control such as your weight, diet, exercise and fitness choices, and lifestyle choices such as smoking.

If you can identify 4 or 5 risk factors above in your lifestyle and could choose one that would have the greatest impact on improving your health; to quit smoking would be the risk factor you’d want to eliminate. Smoking puts a person at risk for a number of life-threatening, deadly diseases and conditions, the first of which is CAD. Not all smokers develop lung cancer, but lung cancer and cancer of the throat, mouth, and sinuses are certainly a major risk. Chronic Obstructive Pulmonary Disease (COPD) is another deadly disease that smokers are at a significantly higher risk for. Complications from smoking include high blood pressure. And since CAD is the number one cause of death in the world, the risk of CAD from smoking is probably the single largest consideration anyone concerned about developing CAD should have.

Exercise and a healthy diet in themselves can fix so many things with your health. With exercise and a healthy diet comes weight loss and more energy. Risk for Diabetes is greatly reduced. Cholesterol levels in the blood improve. People who exercise regularly report feeling less stress and anxiety. Exercise conditions your heart and circulatory system, lowering blood pressure and improving the efficiency of your lungs.

It is easy to look at your current lifestyle if it is unhealthy and feel overwhelmed. People do not suddenly go from a healthy lifestyle to a high risk lifestyle overnight. These choices are made over time. Therefore it is fair to say that changing your lifestyle and making better choices for your health doesn’t come overnight. But make a concerted effort to change the way you live for the better by changing your diet to reduce unhealthy food and increase healthy ones. Or add daily exercise (20 minutes a day). And in a short period of time, 60-90 days, you’ll see a dramatic change in how you feel and the amount of energy you have to face each new day.

Studies show that cardio exercise such as cycling may be key in surviving a heart attack

Studies conducted by Purdue University have shown that cyclists are more likely to survive STEMI Heart Attacks than non-cyclists. Cycling strengthens existing veins and utilizes additional feeder veins; increasing the resilience of your heart.

Studies conducted by Purdue University have shown that cyclists are more likely to survive STEMI Heart Attacks than non-cyclists. Cycling strengthens existing veins and utilizes additional feeder veins; increasing the resilience of your heart. If you have a Widowmaker heart attack and you’re an active cyclist the overall fitness of your heart and circulatory system can give you better odds of surviving it and decrease your recovery time.

Additionally the Purdue study showed that regular cycling has the potential to reduce one’s risk of heart disease by an astounding 50 percent if you cycle just 20 miles a week compared to those who don’t exercise at all. This is significant because a study published in Circulation estimates there are about 250,000 heart disease-related deaths felt to be preventable with adequate exercise.


According to Cycling and Health’s Nick Cavill and Dr. Adrian Davis, cycling utilizes the larger skeletal muscles in a rhythmic pattern with varied periods of rest and active work. The rest periods allow recovery from the high-intensity active periods. In combination with the distribution of body weight, varied breathing and high maximum oxygen uptake; cycling has proven to be an effective exercise for aerobic and physical fitness.

My own experience with CAD is a perfect example – although cycling didn’t prevent me from developing CAD for it was in the cards for me genetically, it did help me “break my family curse” by conditioning my heart and my circulatory system to handle the immense stress that CAD places on your cardiovascular system. I survived and experienced a 100% recovery which is extremely rare because of the conditioning I developed from years of regular cycling.

There is no mistaking that my cardiovascular conditioning was caused by regularly pushing my heart into uncomfortable territory. An AHA White Paper authored by Stéphanie Lehoux and Bernard I. Lévy entitled “Collateral Artery Growth – Making the Most of What You Have” (AHA Journal Circulation Research. 2006;99:567-569 – Originally published September 14, 2006) – states that development of collateral arteries requires 2 adaptation processes that exist in parallel: short term release of vasoactive agonists or changes in vascular tone provide a quick functional adaptation to accommodate rapid changes in metabolic demand, whereas growth or regression of blood vessels (termed vascular remodeling) represent long term structural adaptation to new, lasting metabolic and blood flow conditions.


Simply put your body will react to an increase in blood demand by expanding the capacity of your body’s blood flow to meet short term needs. If the the demand is constant over time your body will react by growing new vascular pathways to meet these lasting demands.

The implication in my specific case is that over years of constantly stressing my heart through daily intense cycling my body reacted by adding additional vascular pathways – NEW pathways – to feed blood to my heart. This growth wasn’t restricted to just my heart. Any muscle group affected by my exercise saw new vascular growth.

The net effect is that when my LAD developed a blood clot due to stenosis and I experienced a Widowmaker STEMI heart attack – the new/additional vascular structures that had developed through years of cycling kept enough blood flowing to my heart that I didn’t experience any tissue death (as is typically the case for STEMI survivors).


First – it is never too late to start exercising and improve your health – even if you have CAD – you can greatly improve you health and reduce your chances for a life-threatening heart attack by exercising moderately for 20 minutes a day. *** NEVER start an exercise regimen without the approval and/or supervision of your physician or a qualified health care consultant! Always follow your doctor’s orders. If you have been diagnosed with CAD baring any inciting incident such as a heart attack – you need to follow your physician’s instructions to avoid potentially life-threatening complications.

I realize that my cycling habit isn’t the norm. I’m extreme. You never need to worry about what other people are doing or how much or this or that. It doesn’t matter. Making wise choices for your health and quality of life isn’t a contest. It’s not a competition.


Start small. Start slow. Ease into more intense exercise over time. “Rome wasn’t built in a day” – an the path to good health through daily exercise takes time. So be patient and have realistic expectations.

Lastly be honest with yourself about why you are doing this. Many people have a hard time committing to daily exercise on the premise that they are working to prevent a disease they may or may not ever develop. The truth is that most people want to exercise to look and feel better. And there is nothing wrong with this as a goal. My suggestion is that if you focus your efforts on the health related benefits of exercise and not the physical appearance aspects you’ll be much more likely to be satisfied with the results of your hard work.