Reasons of Heart Problems in Young Indians Under 40

The whole nation was in shock after hearing multiple news of demise of young faces of India like Sidharth Shukla, Puneeth Rajakumar, Raju Shrivastav, Krishnakumar Kunnath, popularly known as KK, Raj Kaushal and Sathish Kaushik and N Valarmathi. This raises a concern that why are we hearing such news more often? If we look carefully the common cause of death among all the cases was heart attack or other heart problems. What are the reasons behind rise in cases of heart attack in young Indians under 40?

Increase in Heart Problems in Indian Population

The Ministry of Health and Family Welfare on 16th March 2023 in Rajya Sabha have quoted that ‘ the survey conducted by Indian Council of Medical Research (ICMR) in the year 2016 shows that approximately 28.1% of death in India are due to heart diseases’. Sadly this figure was 15.2% in the year 1990.

The associated risk factors: Excessive intake of tobacco & alcohol, unhealthy diet & sedentary lifestyle.

In the USA the overall rate of heart attacks have gone down due to the use of medications like statins and a decline in smoking but these events are slowly rising in very young adults. Therefore the new data presented at the American College of Cardiology’s 68th Annual Scientific Session, shows that heart attacks are common in those under the age of 40.

Why is young heart not healthy?

To get to the answers I took help from google, my MBBS friends and few medical books and Google directed me to several websites and blogs, but none of them gave me satisfactory reasons behind this trend. All of them tries to put blame on any of the the well established risk factors ; smoking, drinking, junk food & lack physical activity. Undoubtedly I was reading different articles but they were all selling me the same old story. I am not trying to say that they was anything wrong with the content, all i am saying is that i am not able to get my head sorted around the fact that how come celebrities, fitness coaches, athletes, and yoga instructors are getting heart attacks. They all are epitome of fitness. So I decided to dig deeper and tried to gather some facts around the true story.

Associated Risk factors

1. High blood pressure/Hypertension causes heart problems

The prevalence of hypertension or high blood pressure in the young adult population is rising in India and the top three risk factors are smoking, mental stress and obesity. As per the census of 2011, approximately 27 million young adults are suffering from hypertension or high blood pressure which is directly correlated with the increased risk of heart disorders.

Read – Fact you need to know about tension in hypertension

2. Type 2 Diabetes

In the people suffering from diabetes, high blood glucose levels can cause severe damage to the blood vessels and the nerves of the body. Over time this damage can lead to heart disease. In fact adults with diabetes are nearly twice as likely to have heart disease as adults without diabetes.

3. Dyslipidemia /High levels of LDL/Bad cholesterol

Dyslipidemia means abnormal levels of fats in blood – higher or lower. Let’s only focus on the high levels of lipids or fats or bad cholesterol part of the story as they one of the major contributors of heart disorders.

Whenever we consume food, our intestine takes up the jobs of absorbing nutrients and deliver them to respective organs via blood. Since fats are not water soluble, so they need a specialized transit vehicles called as lipoproteins, which can help them them to transfer from one location to another in this case the organs will be liver, muscle or fat storing tissues. Imbalance of this transport chain leads to build up of fats in blood which over time being to act as road blocks in blood flow. Disrupted blood flow automatically increases the risk of heart attack.

I will quote one more example for you to understand the dearth of the situation.

There was a study conducted for a period from 1st January 2006 to 31st December 2006, for a period of 1 year. Approximately 1805 subjects in the age group of 40 and above were selected from a population of around 9000 urban area. they used to attend annual general health check-ups conducted at P. D. Hinduja National Hospital and Medical Research Centre. The results show the higher prevalence of dyslipidemia in males than the females. High fat levels were prominent in 31-40 age group than in < or =30 age group.

Covid19 Vaccine

Various cases of blood clots (thrombus) formation either inside blood vessels or a chamber of heart were reported after Covid19 vaccination campaign. In 2022 May, North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences, Shillong, India published a case report of heart attack in a 68 year old male with a history of high blood pressure and non smoking. The patient took COVISHIELD vaccine and suffered from heart attack with 12 hours of time. Fortunately, he was saved by the medical team on time. From that published articles the authors were trying to raise awareness about the possible side effects of the vaccine.

Dr Aseem Malhotra, a British-Indian cardiologist has flagged the serious side effects of heart attack and strokes from COVISHIELD vaccine manufactured in India by the Serum Institute. He also says ‘ the vaccine should never have been rolled out in the country in the first place. The more shots you have the greater the chance of suffering a serious side effect’.

Surprisingly other countries also faced similar situations. In fact Israel National Emergency Medical Services (EMS) reported a 25% increase in call of cardiac arrest and acute coronary syndrome for 16-39-year-old population with possible factors including COVID-19 infection and vaccination rates.

Correlation between heart problems and covid19 vaccine are mere speculations as no concrete evidences are published.

4. Physical Inactivity, Gym and steroids

It seems few people are blaming heavy exercises and gym training for increased rates of heart attacks. There are two factors – exercise and activity. We have to understand that humans are designed to be active and move their bodies throughout their lives. In old times people used to be very active and earn their livelihoods through physical hard work. However, that is not the case anymore. With green revolution, technology, AI and gadgets we can spend whole day sitting in front of screens. So in case we are thinking that by going to gym for 1 hour and not having any movements in the whole day will make us physically fit then we surely we are in a fantasy world. In fact by adopting this kind of life style we are definitely putting our heart at high risk. The sudden act of heavy exercise exerts excessive pressure on heart.

Another commonly observed high risk factor is misuse of steroids among youngsters for bodybuilding and muscle development. In 2020, a case study was published in which a 26 year old male farmer in Brazil suffered from severe heart attack. He used to take androgenic anabolic steroids (AAS) for his body image and the researchers suggested some relationship between use of steroids and heart problems. We can see similar reports in India as well. The use of steroids for is common among body builders and gym practitioners. Hence, authors published a global warning against the abuse of steroids.

References

Mohan V, Venkatraman JV, Pradeepa R. Epidemiology of cardiovascular disease in type 2 diabetes: the Indian scenario. J Diabetes Sci Technol. 2010 Jan 1;4(1):158-70
Unnikrishnan AG, Sahay RK, Phadke U, Sharma SK, Shah P, Shukla R, Viswanathan V, Wangnoo SK, Singhal S, John M, Kumar A, Dharmalingam M, Jain S, Shaikh S, Verberk WJ. Cardiovascular risk in newly diagnosed type 2 diabetes patients in India. PLoS One. 2022 Mar 31;17(3):e0263619
Gupta R, Rao RS, Misra A, Sharma SK. Recent trends in epidemiology of dyslipidemias in India. Indian Heart J. 2017 May-Jun;69(3):382-392
Sawant AM, Shetty D, Mankeshwar R, Ashavaid TF. Prevalence of dyslipidemia in young adult Indian population. J Assoc Physicians India. 2008 Feb;56:99-102.
Sun CLF, Jaffe E, Levi R. Increased emergency cardiovascular events among under-40 population in Israel during vaccine rollout and third COVID-19 wave. Sci Rep. 2022 Apr 28;12(1):6978.
Mishra A, Komut O, Kumar A, Ete T, Megeji RD. Acute Myocardial Infarction After COVID-19 Vaccination: A Case Report. Cureus. 2022 May 31;14(5):e25536ED D
Melhem AJ Jr, Araújo AC, Figueiredo FNS, Figueiredo DLA. Acute Myocardial Infarction in a Young Bodybuilder: A Case Report and Review of the Literature
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