“How did he suffer a heart attack? He was so young and fit.”
These thoughts were left lingering in our minds after the sudden deaths of popular television actor Sidharth Shukla and Kannada superstar Puneeth Rajkumar last year. Both were in their forties. Recently, the death of comedian Raju Srivastava due to cardiac complications has resurfaced the same uncomfortable questions.
Lately, there have been growing concerns about the increasing cases of heart attacks among the youth. According to WHO , heart diseases account for 45% of deaths in the 40-69 year age group in India. Studies  have also shown that Indians get affected by heart diseases at least a decade earlier than Europeans. In fact, we lose the highest number of productive life years due to heart disorders (9.2 million years in 2000; expected to double to 17.9 million years by 2030 ).
Why are young and the seemingly fit Indians becoming prone to heart attacks?
There are three main reasons that make Indians more vulnerable to heart attacks.
Firstly, there is a high genetic predisposition  to heart diseases among Indians.
Secondly, major risk factors of a heart attack like type 2 diabetes, obesity, high blood pressure and cholesterol, are accelerating at an alarming rate among the youth.
And thirdly, certain lifestyle factors like high stress, erratic daily routines, lack of sleep, poor eating habits, lack of or excessive exercise and smoking can all lead to heart ailments in people who are young or seemingly fit.
STRESS may be your heart’s worst enemy!
In the last ten years, work culture has changed drastically. Young Indians have never faced so much mental pressure before. They work in jobs plagued with cutthroat competition, time-bound targets and long working hours, all of which cause high levels of stress.
Health issues, bereavement and job insecurities during the Covid-19 pandemic  have only worsened the situation.
Social media, despite all its advantages, has also become a source of stress for many. The impressionable may feel envious of their friends, strangers or influencers who may paint a rosy picture of their lives on social media. Some also experience FOMO or the “fear of missing out” when they see social media posts of events they’re not a part of.
During such times of stress, the body releases the hormone ‘cortisol’, which reduces the flow of blood to the heart, depriving the organ of oxygen and nutrients.
While this may not harm the heart immediately, effects of high levels of cortisol from long-term stress can be devastating. They can increase cholesterol, blood sugar, and blood pressure, causing plaque build-up in the arteries and increasing the risk of a heart attack.
Effective management of stress in today’s fast-paced world has become the need of the hour.
To combat stress, adopt calming strategies like slowly counting to ten, meditating or taking deep breaths. Learn to prioritize and to say “no” to tasks you feel overwhelmed by. Do not hesitate to ask for help from friends and family. Maintain a positive outlook.
Lack of SLEEP is tied to Heart Attack!
Many youngsters have to burn midnight oil if their clients live in different time zones. Late-night calls can severely impact their sleep pattern and hours. Scrolling endlessly through social media and binge watching the most talked about shows at night don’t help either.
This lack of sleep may cause hormonal imbalance, leading to obesity, diabetes, hypertension and ultimately heart diseases. A study  says that people who get less than six hours of sleep a night have a 20% higher chance of a heart attack.
Therefore, a sound and adequate amount of sleep is the cornerstone of good heart health. At the end of a long day, put down your phone, switch off the TV and lights, and drift off to a peaceful slumber.
Watch what is on your plate!
Hectic lifestyles compel youngsters to eat out or order food online many times a week. They are hooked on processed foods like instant noodles, chips, pizza, burgers, French fries, cakes, etc. These junk foods are loaded with refined flour, sugar, salt, and preservatives that spell bad news for heart health.
While Indian home-cooked meals may seem healthier in comparison, the traditional diet is cereal-based and is deficient in Vitamin D  and omega-3 fatty acids , which are good for the heart. Fixing nutritional deficiencies is therefore a key step toward keeping your ticker in shipshape.
Bask in some sun and supplement your diet with the “sunshine vitamin.”
Include rich sources of omega-3 fatty acids like fish, vegetable oils, walnuts, flax seeds, and leafy greens in your diet.
Exercise – Be cautious of lack or extreme of it!
Being a couch potato isn’t good for your heart; well, neither is being a gym maniac. The idea is to strike the right balance between the two.
Even light-intensity activities can offset some of the risks of being sedentary. Get up from your work desk every once in a while. Walk while attending calls. Skip the lift and take the stairs instead.
Although regular exercise helps to strengthen the heart, strenuous heavy weight exercises tend to increase the immediate risk of a heart attack. This is largely true for people who are at a higher risk, either because of lifestyle or genetic conditions or have any existing blockages in the heart.
So, before you pay for that year-long gym membership, remember to get a thorough cardiac examination and your doctor’s consent.
What if heart diseases run in your family?
Genetics plays a key role in heart diseases but often in combination with other factors.
Genes might load the gun, but diet and lifestyle can pull the trigger.
While you cannot change your genes, you can always mitigate the risk factors of a heart attack.
It is always wise to go for cardiac screening tests like ECG, echocardiogram, stress test, cardiac CT for calcium scoring and blood tests to measure levels of triglycerides, triglycerides/HDL ratio, hs- CRP, insulin, blood sugars and homocysteine once a year or once in 2 years if you:
-Belong to the high-risk group and have crossed age 30
-Belong to the general population and have crossed age 40
Getting to the heart of the matter
Rising instances of heart attack among the youth show that it’s not a disease only of the elderly anymore. So, do not brush any symptoms under the carpet by thinking that you are too young to have one!
In fact, think of your heart health like a savings account. Every time you eat nutritious food, exercise or manage your stress efficiently, you are investing in your health. Make small deposits daily and big returns will happen over time.
(The article is reviewed by Dr. Swati Mishra, Medical Editor)
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