It’s highly likely that the folks reading this are younger rather than older. You’re probably reading this on your computer or phone. Maybe you’re laying in bed, e-commuting to class or, most likely of all, sitting on the toilet. Whatever you’re doing while reading, I’m positive this next part will spark some curiosity, cause you to miss a step or — hopefully, because that’d be funny — produce a combo of the two. Contrary to the invincibility complex of young adulthood’s hype, you, reader, are not too young to have heart disease. Before you object, I challenge you to take a deep breath and keep reading. It could save your life.

I’m propagandist-level enthusiastic about preventive medicine and early intervention because there’s something about being in control of one’s health that feels naturally good. I’m the kind of guy who signs up to get the flu vaccine the first day it’s available at CVS Pharmacy. Who practices intermittent fasting most days of the week. Who’s always on the lookout for new evidence-backed senotherapeutics. Who, after noticing the slightest androgenic alopecia this year, started taking Propecia (it’s working!). I’ve been a runner since 2018, and my waistline (and arms) pleasantly bear witness. I haven’t eaten red meat or pork for half a decade, and I’m not really a natural fan of birds and fish, either. 

I don’t write any of this to build myself up. I work really hard to be well now because I want to be present for others later. I want to be around to meet my great (at least)-grandkids, see life-saving rather than life-extending treatments arrive for humankind’s most offensive cancers and celebrate a majority non-white United States. I have — just as you do and every generation before ours did — a lot of good to offer my fellow humans. The opportunities for us to exceed expectations and right our parents’ wrongs are literally limitless. The way things are going now, though, I just want enough time to finish my education (not necessarily to have to pay back the loans, though).

Which is why I’m writing this. 

I received some blood work Aug. 24, and it looked nothing like it should. Instead of an active, plant-based, health-obsessed 25-year old guy, my veins and arteries look like a 60-year old’s who loves tobacco as much as he hates exercises. I went to see my doctor the next day. Here’s what she told me:

Adult men’s total cholesterol should be less than 200 milligrams per deciliter. 

My total cholesterol is nearly 32 percent higher than it should be. My LDL (“bad”) cholesterol should be less than 100 mg/dL. I’m carrying 65 percent more than that. My HDL (“good”) cholesterol should be 60 mg/dL or higher. I didn’t make the cut-off.

“If we don’t get this under control now,” she said, “you’ve got about a 50 percent probability of living to 60 and roughly 40 percent of having a heart attack before 50.” That translates into a roughly 90-fold increased risk for developing cardiovascular disease in the next decade or so. My stomach twisted into knots of anxiety. I’m not much of a crier, but I felt tears well up. 

Why was my blood so unhealthy? Well, apparently, it’s always been that way. I was diagnosed with a relatively common — if you call one in 250 (0.4 percent) common — atherogenic genetic disorder called heterozygous familial hypercholesterolemia (FH). I’ve had atherosclerotic plaques building in my blood vessels since I was born, and no amount of exercise nor leafy greens would’ve been enough to keep me safe. It means my two sisters each have a 50 percent chance of having it, too. It also means my kids will have a 50 percent chance of being born with it, and that it’s likely behind the very premature death of my uncle.

Just 15-20 percent of individuals with FH are diagnosed and only 16 percent of those individuals are on cholesterol-lowering pharmacotherapy. This is despite medications, known as statins, being extremely helpful for managing FH. Usually, a diagnosis isn’t made until a catastrophic (and completely preventable) cardiovascular event has already occurred, such as myocardial infarction or stroke — an age-unbiased event which can easily be fatal. The reality that FH is very underdiagnosed due to poor awareness in the population combined with the coronavirus’s tendency to damage the human cardiovascular system would spell disaster for folks of all ages with hidden FH — including myself. If I had come down with COVID-19, I would’ve stood little chance. Seeing as COVID-19 doesn’t seem to be going anywhere, knowing what I know now stings a little more.

I’m by no means saying you need to run out and wrangle yourself a cardiologist today, tomorrow or even this month. For many of us, youth is indeed on our cardiovascular side. That said, the coronavirus is a known cause of premature stroke and clotting in young, otherwise healthy people, as well as arrhythmia, myocarditis, cardiac ischemia and sudden death. Fully one in three COVID-19 patients develop cardiomyopathy and in many cases, the virus could increase risks of heart failure. And as we go further into this thing, it’s younger people — like, our age — whose case numbers are on the rise. This should and does concern you directly. The best bet with your health is to know what you’re up against earlier rather than later (when catching up is a lot harder).

The COVID-19 pandemic may be a once-in-a-century occurrence (RIP this CNN piece), but it’s still within the realm of applicability of physicians’ eternal recommendations to eat healthfully, exercise regularly and undergo yearly physical and laboratory examinations. When individuals know the goings-on of their insides, they’re bound to make better health decisions for themselves and others by proxy. Beyond simply reaping the benefits from preventive medicine we all know about — at least abstractly — as young people, knowing our individual numbers empowers us with clearer, fuller choice-making capacity for the present and the future. If you truly want to express bodily autonomy, consider learning about the biological and chemical systems that make you, well … you. 

Be proud of your body and take care of it. It’s the only one you have. Schedule a physical with your doctor, especially if you have a family history of early heart disease, high cholesterol, diabetes or obesity. One last statistic: from an estimate based on the total number of students at the University of Michigan, roughly 192 current Wolverines have FH. They are 192 friends, brothers, students, sisters, sons, daughters, partners. I don’t have to know you to take pride in our shared missions as Wolverines, and the world we have right now can’t afford to lose a single one of us. Know your numbers because youth is no guarantee.

Joshua E. Tucker (he/him/his) is a second-year graduate student in Environmental Health Sciences at the School of Public Health. He can be reached at tuckjosh@umich.edu.

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