Heart-Related Deaths Surge Among Youth in India: Experts Weigh In

A troubling increase in heart-related mortality among young individuals in India has been linked to a combination of genetic factors, unhealthy lifestyle choices, and rising stress levels, according to health experts. On August 16, 2023, officials highlighted these concerns at a health conference in New Delhi, noting that even seemingly healthy young adults have been affected.

The alarming trend includes reports of heart-related deaths among individuals who maintain active lifestyles. Dr. Rajiv Bhal, Director General of the Indian Council of Medical Research (ICMR), stated, “Not all can be classified as heart attacks. Approximately 20 per cent of heart-related fatalities in India are attributable to specific genetic factors.”

Dr. Bhal pointed to several lifestyle issues contributing to this increase, including binge drinking among the youth, silent hypertension, chronic stress, inadequate sleep, and childhood obesity. He cautioned that excessive exercise, particularly in gyms, can exacerbate risks for those with underlying genetic predispositions.

Genetic Factors and Their Impact

The discussion expanded to cover the genetic aspects affecting cardiovascular health. Dr. J.P.S. Sawhney, Chairperson of Cardiology at a prominent hospital in New Delhi, identified two significant genetic causes prevalent in India: familial hypercholesterolemia and elevated lipoprotein(a). Familial hypercholesterolemia affects roughly 1 in 250 individuals globally, but in India, it accounts for heart attacks in 15 per cent of cases among those under 40.

Elevated lipoprotein(a), which is present in 25 per cent of the Indian population, poses additional risks. “We have observed that elevated lipoprotein(a) levels above 50 mg/dL are common in young heart attack patients and are directly linked to the severity of coronary artery disease,” Dr. Sawhney explained.

Diagnosing familial hypercholesterolemia typically requires genetic testing, which is not widely accessible across India. As an alternative, medical professionals employ the Dutch Lipid Clinical Network (DLCN) Criteria for assessment. Dr. Sawhney emphasized the importance of early diagnosis, advocating for cascade screening of family members to identify carriers and initiate treatment as early as two years of age to mitigate the risk of premature heart attacks.

Addressing Lifestyle Factors

While genetic factors are critical, lifestyle choices remain a significant focus for prevention. Dr. Bhal recommended six essential practices for maintaining heart health: engaging in regular physical activity, avoiding smoking, ensuring adequate sleep, adhering to a balanced diet, managing stress, and incorporating meditation into daily routines.

Currently, there is no specific treatment available for elevated lipoprotein(a), but ongoing clinical trials involving new medications may lead to targeted therapies by 2026. Until then, those with elevated levels are advised to aggressively manage other cardiovascular risk factors, including diabetes, hypertension, and cholesterol levels.

As India grapples with this rising health crisis, the emphasis on both genetic awareness and lifestyle modification is crucial. Experts urge a collective response to educate the public about heart health and encourage proactive measures to prevent further loss of life among young individuals.