Adderall, Wine, Diet: A Cardiologist Explains How Your Habits Affect Your Heart

Your heart can break, beat and be worn on your sleeve. It’s sometimes fragile, often overwhelmed and a vital part of your everyday life.

As much as we habitually talk about our hearts, we usually skip the most important part: their health.

Millennials feel too young and fit to worry about heart attacks or disease, although the Center for Disease Control reports heart disease the leading cause of death in the US.

As much as we’d like to believe cardiac arrest solely takes place in the halls of nursing homes and senior centers, in reality that’s not the case.

In your 20s, you’re laying the foundation for later habits, which can build up to a breaking point. With weekend binge drinking and years of birth control under your belt, it’s concerning to realize how much you may not know about the way those decisions affect your heart.

We touched base with Dr. Edward A. Fisher, professor of Cardiovascular Medicine at NYU, who is also the father of former Elite Daily Senior Editor Claudia Fisher. He gave us his take on habits that might be hurting your heart in the long run.

Q: Let's start with the scary stuff. Do heart attacks happen to people in their 20s?

In young people, 30 years or less, it is very rare to have a heart attack. When it happens, it is almost always in those who have had life-long, very high cholesterol levels from a genetic disease called familial hyperlipidemia.

The symptoms are typically like those in older people, crushing chest pain that can “radiate” to the jaw or down the arm.

Q: I can barely remember to check my voicemail, let alone schedule a doctor's appointment. At what age should I start taking my heart health seriously?

Not to depress everyone, but the plaques in the arteries that cause problems like heart attacks and strokes in men and women in middle age and beyond start in childhood. In fact, by age 15 most teenagers in the US have some degree of plaque in the coronary arteries.

It is estimated that half of the risk of having a heart attack is genetic (so choose your parents wisely) and half from modifiable factors, like cholesterol, obesity, smoking, blood pressure. So, the bottom line is that preventive measures -- a heart-healthy lifestyle and awareness of one’s blood pressure, blood sugar, and cholesterol -- should start in your 20s.

Q: It's a good thing I bought a gym membership I can barely afford. How soon will I see benefits?

Except for feeling more fit and having greater exercise capacity, most of the benefits are “silent.” You are investing in reducing your risk of having cardiovascular disease later in life.

Independent of the particular exercise, those that are aerobic seem to have more benefits to keep our heart muscle in better shape.

Q: Okay, so stick to the jump squats. In the interest of my sanity, where do wine and happy hour fit into the cardiovascular equation?

The American Heart Association has recommended that for those who drink (the majority of your readers!) a daily consumption of 1 ounce of pure alcohol a day for women and 2 ounces for men gives cardiovascular benefits without adverse effects on the liver or the brain. This translates to about two beers, two glasses of wine or one cocktail.

Realistically, many people, especially on weekends, consume more. But if you over consume on a chronic basis, you actually lose some of the cardio-protective benefits and run the risk of developing other problems. In full disclosure, I was a co-author of one of the position papers of the American Heart Association on this topic and I make sure I get my two glasses of red wine in on a regular basis.

Q: In college and the workplace, Millennials have a habit of popping Adderall like free candy. What will this do to us in the long run?

According to Dr. Howard Weintraub, another of our [cardiology] experts, Adderall used therapeutically is a useful drug for the people with ADHD. It is a clear sympathomimetic, or a nerve stimulant, and can raise heart rate and blood pressure and cause heart rhythm problems.

He (and I) strongly discourage recreational use of Adderall. It should only be used under the direction of a doctor experienced in its benefits and potential adverse consequences.

Q: Now for the big one, oral birth control. Give us the dets on whether or not our sexual freedom is tied to our health.

According to Dr. Eugenia Gianos, a cardiologist in my center, the decision about whether to take an OCP [oral contraceptive pill] is very much dependent on a woman's individual risk profile which they should discuss with their physician.

Women with heart disease, prior lung clots, prior stroke, hypertension, vascular disease or a family history of these conditions should strongly consider a progesterone based pill, since the risks associated with these pre-existing conditions are mainly from the estrogen component of the pills.

Women should not smoke when they are on oral contraceptives since this greatly increases their risk of having a clot or a stroke.