Times of India
13 January 2010
By Nirmala M Nagaraj & Jayashree Nandi
Bangalore, India

Heart Attacks Are Getting Common Among Those in Their 20s And 30s
The heart now suffers young, thanks to our drastically changed lifestyle. Heart attacks are increasingly being reported among youngsters starting in their twenties and up to late thirties.

Reasons? Stress, sedentary lifestyle, obesity and diabetes, genetic disorders like familial hypercholesterolaemia and many others.

“Definitely, the numbers are on the rise. Heart attacks were unheard of in 30 to 40 years age bracket. In the last couple of years, we are noticing this trend. We see at least one to two heart–attack cases among youngsters every month. It is a big number,” says cardiologist Dr Devananda, who recently operated on a 27–year–old software engineer Rupesh Mathur, who suffered a massive heart attack with severe blockage in three arteries and underwent bypass surgery. According to cardiologist Julius Punnen at M S Ramaiah Narayana Hrudalaya Heart Centre: “Some time ago, we hardly ever saw such cases among people in their 30s. We are getting a fair number of young patients, which shows the trend is increasing. We don’t have official statistics though,” he told TOI.

Young Can’t Take it
The worrying issue is that a young heart is far more damaged and suffers a more dangerous heart attack than that of an older person. “There are a number of technical reasons. In an older person, the calcium settles on cholesterol over a period of time and the heart slowly gets used to the condition. In younger ones, there is a sudden plaque rupture. Even if the vessel has a little bit of cholesterol, it bleeds, which makes the arteries expand and the heart suddenly suffers a massive heart attack,” added Dr Devananada.

Be Positive Participating in extra curricular activities, doing yoga, meditation and having a positive outlook are important. “Several studies show that those who have self–confidence and believe in God have a 50% less chance of having a heart attack. When we close our eyes and pray, the brain releases endorphins, which are 100 times more powerful than morphine given by doctors. As tension reduces and a positive attitude builds up, the body is at peace, this is important for a healthy heart,” said Dr Vijayalakshmi.

Watch Out For Stress Until 1993, not many were aware of the fact that stress can cause heart attacks. It was noticed in Japan, when hundreds of women and adults started complaining of heart problems. However, most of them got better with psychological therapy, that too within 24 hours. This proved stress could cause heart attacks. “This is one of the main reasons why yoga and meditation are popular in developed countries,” said Dr Vijayalakshmi.

Women also Vulnerable
Despite the general notion that women have a natural protection from heart attacks due to their estrogen levels, heart attacks are increasing among them, for smoking has become common. Recently, a 22–yearold girl had to get stents fixed due to artery blockages by Dr Devananda. In the US, however, the problem has come down by 20% due to changes made in workplaces and awareness about physical activity.

Indians Genetically Prone
Indians are genetically more prone to heart disease than Westerners. In the West, the disease sets in in the origins or bifurcations of the large coronary arteries, but among Indians, a good portion of the artery is diseased, and is more diffused. “Due to genetic difference, treatment becomes difficult. The other reason why heart attacks strike the young is because of the earlier onset of diabetes,” he added.

According to cardiologist Dr Devi Shetty, earlier, young sons would bring aged parents for cardiac problems, but, today, it is the reverse with a 60–year–old father bringing his less–than–40–year–old son for heart disease treatment.

“We recently treated a 21 and 22 year old, and, in both cases, the patients were genetically predisposed to the disease. Lifestyle factors affect those in their early 30’s,” he said

Genetic and Lifestyle Disorders
Dr Devi Shetty adds: “Indians are three times more vulnerable to cardiac problems than Europeans. Indian food is rich and in no other food culture is so much oil and carbohydrates used. The increasing non–vegetarian eating habits are also adding to the cardiac problem.” Paediatric cardiologist from Sri Jayadeva Institute of Cardiology, Dr I B Vijayalakshmi said, there are three main causes for heart attacks among youngsters. One of the main reasons is a genetic disorder — familial hypercholesterolaemia. It is characterized by high cholesterol level resulting in severe cardiovascular disease in childhood. Undue stress and pressure, and addiction to junk food, alcohol, tobacco consumption and sedentary lifestyle also cause heart attacks at a young age.

It’s Not New
“This problem was identified ten years ago itself. The youngest patient I treated is a 12 year old, three of his coronary arteries were blocked and he had to undergo bypass surgery. He had a history of familial hypercholesterolaemia. Another case was that of 19–year–old boy who had a massive heart attack. A genetic disorder accompanied by stress caused the attack. But not many are aware of familial hypercholesterolaemia, so even when a active young person dies, it is shocking to most.” said Dr Vijayalakshmi.