It indeed is like a Trojan horse ? what you see is not what really is. In this case you see and feel the stress, but not its implications. And before you know, it boomerangs back ? raising blood pressure, adversely affecting the immune system, increasing the risk of diabetes and eventually leading to cardio-vascular diseases.

35-year-old Mridul Jain became a victim of his own ignorance. Jain, a sales manager in one of India?s leading IT firms never admitted to being stressed. He prided himself of being a ?job hopper? and an avid multi-tasker.? For three years at a stretch he aggressively followed sales targets and juggled euphoria with disappointment in no particular order. With no method to the madness, Jain began to notice things going wrong in his annual health report. To begin with, he noticed that his cholesterol level had risen ? a little over 200. A few months later he complained of slight chest pain and consulted a doctor. A precautionary coronary angiogram revealed a few potential blockages in his heart. ?It would be an understatement to say that I was shocked,? says Jain, who has ?no family history of heart disease, doesn?t smoke or drink (for religious reasons). So, what went wrong.? Stress might explain it to some extent.

?Psycho-social stress is one of the important risk factors in case of cardio-vascular diseases ? almost 20% according to the inter-heart study done in India,? says Dr Parveen Chandra, Director, Cardiac Cath Lab and MI Services, Max Healthcare. ?And considering that most people spend close to 70% of their waking hours at their workplace, it is definitely a major factor.? Up to 10% of the employees that Max Healthcare screens as part of the executive health check-ups, exhibit early symptoms of cardio-vascular diseases. ?Almost 50% of them suffer from high levels of blood pressure and nearly 30% of them have abnormal cholesterol levels,? adds Dr Chandra, as he recollects a 28-year-old youth, driven by ambition, who was diagnosed with a heart problem. ?He thought that it was just a chest problem.?

Most in his peer group think the same way and that?s where the real issue is ? people are entering the risk category too early in life. Controlling the main risk factors can help avoid 80% of premature deaths from heart disease and stroke.

A study by Saffolalife, conducted on 8,469 people across urban India, found 49% of them at risk of heart ailments. The risk levels were found to be particularly highin the 30-39 years age group.

According to the World Health Organisation, almost half of those who die from chronic diseases are in their productive years. And cardiovascular diseases, claming over 17.2 million people each year, is the leading cause of death worldwide. The resultant loss in productivity has tremendous economic consequences. Estimates suggest that between 2005-2015 income loss could rise to as much as $558 billion in China, $237 billion in India, $303 billion in Russia and $33 billion in the UK. ?With 100 million people affected by heart-related diseases, India will be its world capital by 2020,? adds Dr Ravindra L Kulkarni, Interventional Cardiologist, Pune National Heart Institute. ?Heart disease isn?t generally thought of as a young person’s disease, but being young and physically fit is no guarantee the arteries that keep your heart pumping aren?t blocked. An increasing number of young Indians are falling prey to coronary artery disease and stress is one of the key factors,?adds Kulkarni. Possibly a reason why most corporate houses tie up with hospitals to ensure all their employees have a annual health check up done. They realise the adverse affects stress may have. Also, that it helps early diagnosis and treatment of ailments and indirectly contains loss of employee productivity. ?We have been counselling employees to keep their stress levels under check and improving their heart health,? shares Dr Kushagra Katariya, Chief Cardiothoracic surgeon & CEO of Artemis Health Institute in Gurgaon.

?Stress can cause spasm in the heart arteries and can precipitate a heart attack,? says Dr Atul Mathur, Director, Interventional Cardiology, Escorts Heart Institute and Research Centre, Delhi. Escorts too has tie ups with several corporate houses and evaluates a couple of thousand employees each year to find that ?5-10% of them suffer from heart related diseases. And unfortunately, they are not even aware of it,? says Dr Mathur. ?Most,? he adds, ?continue to ignore the early symptoms of breathlessness, chest heaviness etc for a long period of time.? So, clearly while stress is a significant factor at play, there are other factors to be considered as well.

?If you have a positive family history of heart diseases then you definietly need to be more careful. It is known to be genetically transmitted. You also have to keep a tab on your sugar, cholesterol, blood pressure levels and trigylcerides level,? says Dr Mathur. Incidentally, Indians with high levels of triglycerides have been found to have a close association with heart diseases. CT Angiogram, a nearly non invasive procedure, is another new method that he recommends to diagnose even minor blockages in the heart .

That apart, experts suggest, taking a crash course on the art of stress management. Studies indicate that some people handle it better than the others. ?There are two types of personalities Type A and Type B. While the former get worked up with small things, the latter hold the ability to cope with a lot of stress,? explains Dr Mathur. Studies indicate Type A personalities to be at 80% more risk of high blood pressure. It also predisposes them to a greater risk of heart disease.

?Stress over a period of time can be harmful. And this time frame varies from person to person,? says Dr Katariya adding that stress can increases the mismatch between the demand and supply of oxgen to the heart to a level that it results in a heart attack. In a nutshell, bust the stress, or identify the Trojan Horse before your heart begins to regret it.

WARNING SIGNS OF STRESS

Physical signs

Dizziness, general aches and pains, grinding teeth, clenched jaws, headaches, indigestion, muscle tension, difficulty sleeping, racing heart, ringing in the ears, stooped posture, sweaty palms, tiredness, exhaustion, trembling, weight gain or loss, upset stomach.

Mental signs

Constant worry, difficulty making decisions, forgetfulness, inability to concentrate, lack of creativity, loss of sense of humour, poor memory.

Emotional signs

Anger, anxiety, crying, depression, feeling powerless, frequent mood swings, irritability, loneliness, negative thinking, nervousness.

Behavioural signs

Bossiness, compulsive eating, critical attitude of others, explosive actions, frequent job changes, impulsive actions, increased use of alcohol or drugs, withdrawal from relationships or social situations.

Risk busters

•There are 400 million adults worldwide who are obese and 1.6 billion who are overweight. Children are getting fatter too. Worldwide, 155 million children are overweight, including 30-45 million obese children.

•A diet high in fresh fruits and vegetables promotes heart health. Low fruit and vegetable intake accounts for about 20% of cardiovascular diseases.

•Hypertension is a major risk factor for cardiovascular diseases. A diet high in sodium increases the risk of developing hypertension. As per estimates, a universal reduction in dietary intake of sodium by about 1g of sodium a day would lead to a 50% reduction in the number of people needing treatment for hypertension.

•Physical inactivity increases the risk of developing heart disease 1.5 times and doubles the risk of developing type 2 diabetes.

•There is a two-fold risk of death by cardiovascular diseases among smokers compared to non-smokers.

World Heart Federation