Too often, young people in the U.S. just on the threshold of adulthood face cardiovascular challenges.

By the time they’re 18, many teenagers will have heart disease risk factors such as obesity, high cholesterol, high blood pressure or Type 2 diabetes. Some will already have heart problems.

Use of tobacco products remains a concern. So is a lack of health insurance.

A new scientific statement from the American Heart Association outlines such health challenges, highlights some underlying causes and explores ways to help this population, still young in years, remain physically young at heart. The report was published Wednesday in the Journal of the American Heart Association.

“Emerging adults” – a term for people age 18 through their mid- to late 20s – face a host of life changes as they begin to experience greater independence, develop their careers, forge new personal bonds and chart their life course, Dr. Jewel Scott, chair of the report’s writing group, said in a news release.

“This pivotal phase is also an ideal time to establish health practices that support lifelong heart health,” said Scott, an assistant professor of biobehavioral health and nursing science in the College of Nursing at the University of South Carolina in Columbia.

Young adults’ growing responsibilities in education, work and family can disrupt healthy eating, make getting sufficient sleep difficult and displace beneficial activities such as athletics, according to the statement. Increases in sedentary behavior and weight are common in this age group. Also, research shows that from 2002 through 2018, the percentage of people ages 18 through 23 who started using tobacco, primarily e-cigarettes, more than doubled.

And when young people leave pediatric health care behind, standard medical “checkpoints” – such as appointments for vaccines or sports physicals – fade into the past. So opportunities dwindle for health care professionals to measure blood pressure, blood sugar and cholesterol, and to help head off any threats to heart health.

“Young adults may not re-engage with care until after they’ve developed a heart disease risk factor,” Scott said.

Pregnancy poses its own challenges to cardiovascular health. Heart-conscious care before and between pregnancies can help protect the patient’s future cardiovascular health and prevent pregnancy complications such as gestational diabetes, preeclampsia and pre-term birth, according to the statement.

Various social circumstances can also influence cardiovascular health in young adulthood and beyond, the report said. For example, higher education is linked to better heart health, while other factors are linked to poorer heart health. These include:

– neighborhoods that are segregated, have fewer resources, lack safe spaces for physical activity and have less access to clean air and water;

– a person’s lack of positive social connection and support; and

– economic instability, which can reduce access to health care and nutritious foods.

To address these social factors, the report’s authors suggest incorporating the essentials of heart health in early education through college or vocational school; working to reduce isolation among young adults; and promoting public policies that address social and economic inequities, improve access to safe recreational areas, and fill health insurance access gaps across the lifespan.

Emerging adults make up the largest share of the 27 million uninsured adults in the U.S., the report said. Many lose coverage from their parents’ health insurance when they turn 26. And Medicaid eligibility for young adults with low incomes can depend on whether the state they live in has expanded Medicaid access.

Even if they’re insured, young adults might avoid health care because they’re unfamiliar with services, have had negative experiences with health care or are put off by other issues such as long wait times, the authors wrote.

Harnessing social media and other digital tools may help connect young adults with needed care, the statement said. The authors also urged researchers, health care professionals and public health experts to think creatively about life settings where they might reach young adults – at community colleges or universities, in the military or through veterans services, or in places they commonly work, such as in the hospitality field.

Scott called on health care professionals to make heart health a priority for young adults during any office visit.

“We may see their blood pressure is a little high, but we don’t address it because they came in with an ear infection or sprained ankle or something else that needs immediate attention,” she said.

“We may miss the opportunity to let them know that they are in the elevated blood pressure range and ways they can take action. We need to have these conversations.”

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American Heart Association News covers heart and brain health. Not all views expressed in this story reflect the official position of the American Heart Association. Copyright is owned or held by the American Heart Association, Inc., and all rights are reserved.