An analysis of 5,000 patients seen at the State-run Jayadeva Institute of Cardiovascular Sciences in the last five years — all aged below 40 — revealed that over 30% of the cases did not face any conventional risk factors or family history. While 51% were smokers and 10% had high conventional risk factors, 15% had a strong family history of premature heart attack, indicating that there is some definite genetic predisposition.
In fact, the premier cardiac care institution has recorded a 22% increase in the incidence of heart attacks among youngsters in the last 10 years.
Attributing this trend to multiple risk factors, including conventional factors such as diabetes, smoking, sedentary lifestyles, and family history, doctors said stress, air and soil pollution also had a great impact. Proper and early risk factor and lifestyle management is the key to prevent cardiovascular problems, doctors said.
COVID factor
Underlining the need for stress management, institute director C.N. Manjunath told The Hindu that stress levels were best assessed by the individuals themselves. “COVID-19 has added to the stress and we have seen a marginal rise in the number of patients reporting cardiac issues post COVID-19,” he said.
“While heart attack-related disease (coronary heart disease) is coming down in Europe, United States of America, and Japan, it is high in India mainly because of stress and sedentary lifestyle. Even school-going children and their mothers are under tremendous stress. In fact, a child’s education has become a mother’s examination,” the doctor said.
“We have to focus on preventive interventions from childhood. Policymakers have to take a call and in my opinion, schools should function between 10 a.m. and 1 p.m. at least till second standard. Otherwise stress begins from childhood,” he said.
“Those with a strong family history of heart attack and multiple comorbidities should take precautions and undergo regular medical checks. Apart from quitting smoking and alcohol and keeping diabetes and BP under control, stress management is extremely important,” the doctor explained.
Workplace wellness
Asserting the need for workplace wellness, Dr. Manjunath said workplaces should have leaders and not bosses. “There has to be a cordial atmosphere and good work should be complimented. Only medicine cannot reduce stress or disease,” he said.
Dr. Manjunath said some people have an excessive tendency for clot formation in their bodies. “In those with no conventional risk factors, a heart attack cannot be predicted as there is a sudden rupture of plaque in the arteries. There is no indication even a minute before the attack. It is unfortunate that only a lucky few (around 10%) make it to the hospital and survive,” he said.
Sudden deaths
Vivek Jawali, chairman, Cardiovascular Sciences and Executive Council of Fortis Hospitals in Bengaluru, said according to 2019 data from ICMR and AIMS, almost 30% of sudden cardiac deaths were among youngsters.
“Indians definitely suffer more. Traditional risk factors that you see around the globe are much higher in India, whether it is fatal programming or more prevalence of metabolic syndrome among Indians. The incidence seems to be more in the South than in the rest of the country,” he said.
CPR training
There is a need to create awareness and train non-medical people about cardiopulmonary resuscitation (CPR), said C.N. Manjunath, director of Sri Jayadeva Institute of Cardiovascular Sciences and Research. CPR is an emergency procedure that can help save a person's life if breathing or heart stops. “We need to have some people trained in CPR in malls, public places, gated communities, apartments, and gyms. At Jayadeva, we are training all our employees in batches,” he said.
BMTC MoU with Jayadeva
The Bangalore Metropolitan Transport Corporation (BMTC) last month entered into a memorandum of understanding (MoU) with Sri Jayadeva Institute of Cardiovascular Sciences to get cardiac evaluation done for all its employees aged above 45.
“We have started looking at the health status of BMTC drivers and are evaluating 150 employees every week. We plan to cover all the employees in the next nine months,” said C.N. Manjaunth, institute director.
“So far, we have found a majority of those tested have high BP and diabetes. Smoking history is being underestimated because many are reluctant to reveal this addiction,” the doctor added.
