How Early Is an “Early Death?”

How old is 45, really?

How many heart attacks did your grandfather have? My grandfather had five. The first happened before his 35th birthday and was in large part unremarked upon; he only discovered it was a heart attack after his second one, a few years later, which briefly put him in the hospital. (He’d assumed the first one was indigestion.) His third one, when he was 45, didn’t even force him to miss a day of work. I asked my Dad, who started taking blood pressure medication in his 30s, if my Grandpa ever took any medicine to help with his heart problems. He said that one time, to get his heart “back aligned,” a doctor put him in a dark room and clapped loudly and unexpectedly in his ear to try to “scare it right.” This was in the 1950s. I do not think it worked.

My grandfather — whom I am named after, William Franklin Leitch — made it to the age of 67 before his body gave out on him; he was smoking his unfiltered Pall Malls on his death bed. My father turned 68 a few years ago and admitted he was unsettled by living longer than his father had. But he shouldn’t have been. My father, with the same genes as his dad, quit smoking 40 years ago and has been enjoying the pleasures of modern medicine for decades. He’s 72 now, and I believe we have many more years together. I might not have felt that way 40 years ago. But I do now.

I thought about my grandfather’s first heart attack yesterday when I learned that Julio Lugo, a former Major League Baseball player (he was in the Majors as recently as 2011), had died of a heart attack at the age of 45. Lugo by all accounts was healthy — he was a former professional athlete, after all, one just a-year-and-a-half older than Tom Brady — and his family was legitimately shocked by his death: No one saw it coming. But then again: He was 45. Is that too young for a heart attack? Are we sure?

Put it this way: 45 is an age that is old enough that, when someone has a heart attack, you don’t immediately think, “Oh, it must have been a drug overdose.” You can die at 45 in the normal ways that people die. You can die at 45 because your body just got old.

Obviously, it is rare. The average life expectancy in the United States in 2020 was 78.1 years old, which actually went down from 78.95 in 2015, the first time it has gone…