Heart attacks can affect nearly anyone, but a recent study from researchers at the Cleveland Clinic illustrates a startling trend. According to a report from CBS News, researchers found that heart attack patients, on average, are younger and fatter than ever before.

The study’s findings will be presented at the American College of Cardiology’s 65^th Annual Scientific Session. Researchers also showed that people suffering from heart attacks are more likely to have additional risk factors like hypertension and diabetes, which are both largely preventable. Smoking was another rising common factor in heart attack sufferers.

According to lead author Dr. Samir Kapadia, a professor and interventional cardiologist at the Cleveland Clinic, “On the whole, the medical community has done an outstanding job of improving treatments for heart disease, but this study shows that we have to do better on the prevention side. When people come for routine checkups, it is critical to stress the importance of reducing risk factors through weight reduction, eating a healthy diet and being physically active.”

Dr. Kapadia and his research team examined heart disease risk factors across a sample of nearly 4,000 patients who had been treated for one of the most severe and fatal types of heart attacks. Researchers looked at ST-elevation myocardial infarction, or STEMI records kept at the Cleveland Clinic from 1995 to 2014. A STEMI heart attack occurs when a coronary artery becomes blocked.

This prevents a significant portion of the heart muscle from receiving blood, which causes the circulatory system to go into shock and shut down. Immediate care from a cardiologist can increase a person’s chances of surviving this kind of heart attack, but mortality rates remain high.

The study highlights the fact that there is still much to be done in the way of embracing healthy habits and taking preventative measures to reduce the possibility of a STEMI heart attack. There are a number of known risk factors, and while some can’t be controlled, a number of them can.

Age and family history play a role in determining the risk of a person suffering from a heart attack, but other factors can contribute significantly to the risk. Many of these factors are a function of simple lifestyle choices. Smokers, overeaters, and people who don’t get enough exercise all face a significantly higher risk of suffering a heart attack than people who maintain an active lifestyle.

“Very amazingly, what we found was the patients presenting with ST-elevation myocardial infarction were getting younger,” said Dr. Kapadia. The study revealed that the average age of a STEMI sufferer dropped from 64 years old to 60 years old between the first and last five-year time segments.

Patients were also getting fatter – 31 percent of STEMI sufferers were obese in the first time segment, while 40 percent were obese in the last five-year span. The proportion of patients with diabetes, hypertension, and chronic obstructive pulmonary disease all increased over time as well, by 7, 22, and 7 percent respectively.

The researchers also noted a sharp uptick in the number of smokers being admitted for heart attacks. Among the patients admitted for STEMI, the proportion of smokers rose from 28 percent to 46 percent over the span of the study. Patients who had three or more risk factors rose from 65 percent to 85 percent.

According to Dr. Mary Norine Walsh, the vice president of the American College of Cardiology, “Risk factor reduction in the broader population has been documented, so it is concerning that, at this institution, risks seem to have risen over 20 years. Much larger studies, involving large population groups and many hospitals would be needed to determine if these findings hold true more broadly.”

While the study only examined a single sample from one hospital, the findings paint a bleak picture for preventative care in the U.S. If the results can be replicated, we may be facing a huge national issue that is taking a huge toll on healthcare systems and families alike.