Heart attack, also known as myocardial infarction (MI), is the number one cause of death in the world today, especially in India. It occurs when the blood flow to the heart muscle is severely reduced or blocked. If treatment is delayed, part of the heart supplied by that artery begins to die. Recent trends show a concerning rise in heart attacks in young adults—especially among Millennials and Gen Z—due to lifestyle diseases, stress, and post-COVID complications.
As per the study report, "India's Health of the Nations States” in 2017, indicated that the percentage of deaths from non- communicable diseases (NCDs) increased from 37.9% in 1990 to 61.8% in 2016. The four primary NCDs include cardiovascular diseases, cancers, chronic respiratory diseases and diabetes.
Heart disease in young adults India is becoming an alarming concern. Research shows that many young Indians may develop cardiovascular risk factors early in life, underscoring the importance of heart health prevention through regular screenings and lifestyle changes.
India has an alarming rise in heart diseases. The National Crime Records Bureau (NCRB) noted a 12.5% rise in heart attacks in 2022, with more cases in people aged 25 to 45, especially post- COVID. Experts link this rise to Millennials’ heart disease risk factors such as stress, sedentary lifestyles, and poor diet.
Countries like India are witnessing a growing impact, particularly among those under the age of 45. Some studies suggest that South Asians may have higher coronary artery disease risk due to genetic and metabolic factors, including differences in vessel structure, lipid metabolism, and insulin resistance while factors such as hypertension, obesity, family history and diabetes further increase the risk.
Heart disease among young Indians often presents without classic symptoms and may sometimes manifest as sudden cardiac death, highlighting the urgent need for early screening and preventive care (Loitongbam and Surin 2024).
Sudden deaths can also be caused by undiagnosed heart problems such as arrhythmias (irregular heartbeats), cardiomyopathy (thickened heart muscle) and congenital heart defects, rather than obstruction.
What is this latest trend? Why are young Indians at risk?
MedBound Times reached out to Dr. Sandeep Mohan, Senior Consultant – Interventional Cardiology, Aster MIMS, Calicut to share his valuable insight on this.
Two important things can take place. The first one is an underlying undetected coronary plaque, which varies from 30 to 99 percent, coupled with risk factors such as a family history of heart attacks, diabetes, high blood pressure, elevated cholesterol levels, poor dietary habits, and insufficient physical activity. Secondly, triggers such as lack of sleep, stress, depression, sudden physical exertion- often seen in younger individuals, can cause the plaque to rupture, leading to a heart attack
Dr. Sandeep Mohan, MBBS, MD, DM (Cardiology), DNB (Cardiology), MRCP UK (London), FSCAI, Senior Consultant – Interventional Cardiology, Aster MIMS, Calicut.
Work-life imbalance: Long working hours, job insecurity, excessive screen time, fewer activities, and limited gatherings are all factors that add stress to the heart.
Smoking, vaping, and alcohol: These habits start as a cool trend but can lead to addiction and cause significant harm to the body. Over time, they weaken the heart muscle, leading to irregular heartbeats (arrhythmias) and raised blood pressure.
Diet: Junk foods, sugary drinks or snacks, along with a sedentary lifestyle, increase the risks of heart attacks. Maintaining a healthy body weight is essential.
Hypertension and diabetes: Both conditions increase stress on the heart, predisposing to heart attacks and stroke.
Substance abuse: Recreational drugs or performance-enhancing drugs like opioids, amphetamines, cocaine, and cannabis have high addiction potential and increase the chances of heart attacks.
Sleep disorders and poor mental health: Sound sleep has become as rare as sparrows in the cities. Even at a young age, only few individuals are fortunate enough to get this luxury. Additionally, numerous millennials and Gen Zs are suffering from sleep disorders, anxiety, depression, and other mental health issues, all linked to poor heart health. When was the last time, you just dozed right away, without looking at any screens, for a good eight hours, feeling refreshed and not irritated upon waking up?
Oral health: Several studies have explained the association between poor oral health and cardiovascular diseases. Oral bacteria are known to induce platelet activation, aggregation, and thrombosis, thus increasing the risk of heart attack.
MedBound Times also reached out to Dr. Divya Nair, Periodontist and Implantologist at Pearl Dental Clinic, Dubai, to share her insights on the possible correlation between oral health and cardiovascular health.
Inflammation is the key link between these two conditions. In periodontal disease, bacteria in the mouth trigger a constant inflammatory response. These inflammatory markers can then enter the bloodstream, causing or worsening inflammation in other parts of the body, including the arteries. This continuous inflammation is a known driver of heart disease and atherosclerosis.
Dr Divya Nair, BDS, MDS, Periodontist and Implantologist at Pearl Dental Clinic, Dubai
C-reactive protein (CRP) — a major inflammatory marker — is often found elevated in patients with both periodontal disease and atherosclerosis, suggesting a biological connection between oral inflammation and cardiovascular risk (Libby et al. 2024).
COVID-19: Researchers indicate that individuals who were infected by COVID- 19 are at higher risk for heart attack, stroke, and sudden death than individuals who were not infected.
Steroid use: Nowadays, steroids are commonly used for various purposes such as to improve athletic performance, to increase libido, to build muscles or to improve physical appearances. But, prolonged use and inappropriate doses without doctor’s prescription can cause significant issues in body and cardiovascular health, with sudden cardiac arrests being one of the major risks.
Sudden cardiac arrest in gym: Gym is not directly related to cardiac deaths. Inconsistent exercise or excessive working out along with high intensity endurance activities after an extended period of inactivity can place excessive stress on the heart. Factors such as dehydration, absence of warming up , electrolyte imbalance, can further worsen the condition. Moderate exercise is safe, including for those with cardiovascular disease.
Symptoms may vary from mild to severe:
• Chest pain, feels like pressure, tightness, or squeezing
• Pain or discomfort in the arm, shoulder, back, neck, or jaw
• Heartburn or indigestion
• Sweating, tiredness, or dizziness
• Shortness of breath
Women may experience symptoms differently, like upper back pressure, anxiety, shortness of breath, and upset stomach.
Regular exercise
Avoid smoking or vaping
Get 7 to 8 hours of sleep
Eat a high-fiber, balanced diet
Schedule regular screenings
Dr. Sandeep Mohan also provided his insights on preventive measures:
If there is a family history of heart attacks, begin regular check-ups by the age of 30. Tests for cardiac assessment include ECG, echocardiogram, treadmill testing, CT calcium scoring, stress echocardiography, MRI scanning, PET scanning, CT coronary angiography and ultimately the definitive gold standard routine coronary angiography. But, the choice of the most suitable test can only be determined by a cardiologist, so consulting one is essential.
MBBS, MD, DM (Cardiology), DNB (Cardiology), MRCP UK (London), FSCAI. Senior Consultant, Interventional Cardiology. Aster MIMS, Calicut.
Conclusion
Heart attacks are no longer limited to the elderly. Many cardiac problems might exist silently for a long period of time with no symptoms. Prevention and regular visits to a cardiologist can help lower the risk of a heart attack.
References
Hilser J. R et al. 2024. COVID-19 is a coronary artery disease risk equivalent and exhibits a genetic interaction with ABO blood type. Arteriosclerosis Thrombosis and Vascular Biology, 44(11), 2321–2333. https://doi.org/10.1161/atvbaha.124.321001
Sethi Y, Rajagopal V, Choudhary A. K, Agstam S, Dahiya N. 2023. Why are young people dying of heart attacks these days: what is the evidence? The Evidence, 1(1), 72–77. https://doi.org/10.61505/evidence.2023.1.1.10
Liu, Jian-Di, and Yan-Qing Wu. 2019. “Anabolic-Androgenic Steroids and Cardiovascular Risk.” Chinese Medical Journal (Engl.) 132 (18): 2229–2236. https://doi.org/10.1097/CM9.0000000000000407
Mannakkara, Nilanka N., and Gherardo Finocchiaro. 2023. “Exercise and the Heart: Benefits, Risks and Adverse Effects of Exercise Training.” Reviews in Cardiovascular Medicine 24 (3): 94. https://doi.org/10.31083/j.rcm2403094
Loitongbam, Linthoingambi, and William R. Surin. 2024. “The Rising Burden of Cardiovascular Disease and Thrombosis in India: An Epidemiological Review.” Cureus 16 (11): e73786. https://doi.org/10.7759/cureus.73786
Libby, Peter, et al. 2024. “C-Reactive Protein and Inflammation in Atherosclerosis: Revisiting the Link.” Nature Reviews Cardiology 21 (2): 85–97. https://doi.org/10.1038/s41569-023-00968-5
Reviewed by Dr. Sumbul, MBBS, MD (Anatomy)
MSM
