Young hearts at risk: How lifestyle and environment are fueling early heart attacks

Although delayed, it is a welcome trend to see the buzz around heart issues that individuals are facing at a much younger age. It is hoped that this development will translate into much-required sensitization and transformational changes toward prevention and protection.

Consequences of modern lifestyle choices
At the outset, the raise of heart attacks at younger age, looks like a sudden and dramatic occurrence, compelling everyone to blame it upon COVID infection and vaccine, which is fresh in public memory as a culprit. However, we tend to miss the decadal demographic change and shift in lifestyle and disease trend. A simple reflection on how modern lifestyle (diet and physical activities), environmental, occupational changes, work culture, long working hours, lack of sleep and relaxation, will explain the disease trend that is catching up. Humankind has witnessed a monumental shift from an era where everyday living required physical activity from hunting, gathering, nomadic life, and outdoor sports to mechanisation, mobility on wheels, home deliveries, onscreen entertainment and desk jobs leading to zero movement outside our doorstep.


Surge in edible oil consumption
On one side, India’s GDP is burdened by 85-90% of petroleum crude oil imports. At the same time, the country’s demand for cooking/edible oil is also met by 55-60% through imports. A recent data on the edible oil consumption trend can be a startling reflection of the health and disease trend in the country, wherein, India’s per capita edible oil consumption has nearly tripled in two decades. While it was just 8.2 kg in 2001, it has significantly risen to a per capita annual consumption of about 23.5 kgs in current times. This marks a substantial increase from the mere 2.9 kg in 1950-60s, which is exceedingly higher than the recommended limits of 12-13 kg by ICMR and WHO. This consumption pattern seems to be driven by rising incomes, urbanisation, assurance of government schemes, a noticeable change in dietary habits, advertisements influencing consumer behaviour, blind following of western dietary habits, a lack of self-control and thoughtfulness, and a misplaced sense of affluence.

Major risk factors
Both health and disease are evolving concepts that are never static. For example, our understanding of heart attack is still incomplete, as about 15-25% of cases—and an increasing number overall—occur without the presence of traditional risk factors like high cholesterol, high blood pressure, smoking, or diabetes. Heart attacks can still occur with normal cholesterol levels, hence reflecting a complex interplay of multiple factors in its causation. With traditional risk factors on one side, there are newer compelling and growing reasons why people can suffer heart attack. Some of them include COVID infection, chronic stress and mental health issues, SCAD (spontaneous coronary artery dissection), air pollution or substance abuse like cocaine and amphetamines. Air pollution with acute and chronic exposure to PM 2.5 (particulate matter 2.5) is one of the leading contender in the causation.

Steps toward change
It is time to introspect on where we lost the track and take course corrective measures to start inching towards healthy practices. Japan for example has one of the lowest rates—about one third to one fifth lower than the United States—and was able to reduce coronary heart disease (CHD) and its mortality by 61% between 1980 and 2012 through various broad spectrum holistic interventions leading to reduced BP, smoking, obesity, BMI, cholesterol, and diabetes among its population. This can be an encouraging point for countries like us to follow the model on public health intervention to safeguard our population from adverse health, social, financial and GDP implications of young age heart attacks.

(Dr. Pradeep Haranahalli, Consultant – Interventional Cardiology, Manipal Hospital Whitefield)