By Sreya Deb
India is staring at a significant public health concern—a cardiovascular disease epidemic that is increasingly affecting younger individuals. While heart ailments are more common in older adults, Indians suffer heart attacks 10 years earlier than Westerners, as per reports. Also, nearly two-thirds of all cardiovascular deaths in India are premature, according to a study published in The Lancet.
“Early-onset heart disease is particularly dangerous because it impacts the most productive years of life,” says Dr Mukesh Goel, senior consultant, cardiothoracic and cardiovascular surgery, heart and lung transplant surgery, Indraprastha Apollo Hospitals, New Delhi. Early-onset heart disease refers to the development of heart conditions, particularly coronary artery disease (CAD), at a younger age than typically expected.
There have been reports linking the Covid-19 vaccine with deaths in young people from cardiac arrest. The issue was back in the spotlight after Karnataka CM Siddaramaiah recently claimed that the Covid-19 vaccines may be linked to a surge in sudden cardiac deaths in the state’s Hassan district.
However, studies by the Indian Council of Medical Research (ICMR) and the National Centre for Disease Control (NCDC) have now affirmed that the vaccines are safe and effective, with extremely rare instances of serious side effects. An ongoing study being conducted by AIIMS, New Delhi, too, claims that there is no link between the Covid-19 vaccine and deaths in young people from heart attacks.
The usual suspects
So, what’s leading to a rise in premature heart diseases? According to health experts, sedentary habits, long screen hours, high stress levels, erratic sleep cycles, and diets high in processed foods, sugars, and trans fats are all contributing to poor heart health. However, there are other non-lifestyle related reasons as well, such as a genetic predisposition, hypertension, and others.
As per Dr Prashant Nair, consultant, cardiology, Kokilaben Dhirubhai Ambani Hospital, Mumbai, although the lifestyle of the average Indian youth can be hectic, it does not mean that they cannot incorporate heart-healthy practices. “The key lies in building awareness and prioritising long-term wellness. Small yet consistent changes like walking 30 minutes a day, taking stairs, eating home-cooked balanced meals, sleeping for 7-8 hours, managing screen time, and de-stressing through hobbies or mindfulness can make a massive difference,” he says.
Speaking from his experience, Dr Nair says, “There have been instances where first-time heart attacks have occurred in the early 20s. These patients often have undiagnosed risk factors or may be dealing with extreme stress, performance-enhancing drugs, or smoking habits. These cases are a wake-up call that youth does not guarantee immunity.”
Waiting till symptoms appear can be fatal, Dr Nair suggests. “Preventive screening, even in asymptomatic individuals, can identify risk factors early and help reverse damage,” he adds.
According to Dr Goel, social media-induced anxiety and sleep cycle disruptions from prolonged gadget use also indirectly add to cardiovascular risk. “These risks are amplified in those with a family history of heart disease,” he says, adding: “Heart health is not just a concern for the old anymore.”
If there’s a family history of heart disease, doctors advise screenings should begin even earlier, around 18 to 20 years. “We’re also seeing a rise in young gym-goers misusing supplements or steroids, which can dangerously impact heart rhythm and pressure. The younger the patient, the more devastating the long-term effects can be,” adds Dr Goel.
The Indian scenario
Indians are genetically predisposed to develop CAD at younger ages and lower body weights compared to Western populations, medical research has shown. Dr Goel expounds, “This is compounded by high rates of diabetes, central obesity (fat around the abdomen), and metabolic syndrome. Our diet, rich in carbohydrates and trans fats, and a relatively sedentary urban lifestyle add to the risk. Cultural habits like delayed health checkups and underestimating symptoms further increase vulnerability. “Moreover, vitamin D deficiency and low HDL levels, which are frequent in Indians, make heart health a critical area of concern,” he adds.
Studies have shown that Indian bodies tend to have higher levels of lipoprotein(a), smaller coronary arteries, and a greater tendency to develop insulin resistance, shares Dr Nair. “When this inherent risk is compounded with lifestyle issues… it significantly accelerates the disease onset,” he adds.
“The damage is not just to the heart, but also to the brain (via stroke), kidneys, and other organs that rely on strong circulation. Early-onset heart disease drastically reduces both lifespan and health span,” he further explains.
In comparison to the global average, the age-standardised DALY (disability adjusted life years) rate of ischemic heart disease is 1.6 times higher and that of rheumatic heart disease is 2.4 times higher in India. The CVD related age standardised DALY rate has been reported to be 1.3 times the global average.
This tendency of Indians diagnosing with heart diseases more frequently than other nationalities is often referred to as the ‘South Asian paradox’ where even individuals with normal body weight may have dangerous levels of visceral fat, increasing their cardiac risk.
A report released in 2014, illustrating a projection from the year 2012 to 2030 and published by the World Economic Forum and the Harvard School of Public Health, estimated that the economic losses India would suffer due to cardiovascular diseases would be to the tune of over $2.17 trillion.
Preventive cardiology
“Preventing poor heart health requires a lifelong commitment-but one that pays rich dividends,” says Dr Nair, adding: “The answer lies in preventive cardiology.”
As for adoptable habits to prevent heart disease, Dr Nair advises teaching children about healthy eating from a young age and encouraging physical activity early on. Schools and workplaces should adopt heart wellness programmes, and one should maintain a balanced, nutrient-rich diet low in sugar, salt, and processed food. “Young adults should also undergo annual health screenings, especially if there’s a family history of heart problems,” warns Dr Goel. Managing weight, monitoring blood pressure, cholesterol, and sugar levels from the early 20s is key to long-term heart health, he says.
Dr Goel, too, reiterates that young individuals should make physical activity a daily priority and aim for at least 150 minutes of moderate exercise weekly. “Regular sleep and stress management techniques like meditation, yoga, or simply taking digital breaks are vital,” he adds.
