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Television and film Actor Nitesh Pandey, known for his roles in the series Anupamaa, passed away due to a cardiac arrest, on 23 May, according to reports. He was 51. According to reports, the actor was shooting in Igatpuri in Maharashtra, where he suffered a fatal heart attack at around midnight.
If this recent slew of fatal heart attacks tells us anything, it is that heart attacks are not just an old-people problem like they were thought to be.
Mounting evidence in recent years suggests that there isn’t such a thing as ‘too young for a heart attack,’ any more.
According to data from the Indian Heart Association, around 50 percent of the heart attacks in India occur in people below the age of 50.
A study conducted by the Trinity Hospital in 2013 also found that 900 Indians under the age of 30 die of heart attack every day.
So, what’s going on here?
Why are so many young, seemingly fit and healthy people having fatal heart attacks?
Let’s break it down.
What Causes Heart Attacks?
Heart attacks are basically caused by blockages in arteries directly connected to your heart. And what causes these blockages?
"When cholesterol starts depositing into the arteries, it gradually builds up from a small bulge to a significant level. When it reaches a level where it is more than 70 - 80 percent, then the person starts noticing symptoms," explains Dr Vishal Rastogi, Director, Interventional Cardiology, Fortis Escorts Heart Institute, New Delhi.
"We are seeing more and more patients at a younger age. We used to misdiagnose these young MIs (acute myocardial infarctions) very frequently earlier because we would not suspect that the person is having a heart attack."Dr Vishal Rastogi, Director, Interventional Cardiology, Fortis Escorts Heart Institute, New Delhi
Dr Rastogi goes on to say that this also leads to many young people ignoring their symptoms and not seeking medical attention till it's too late.
Some of the most common causes of heart blockages and heart attacks in this age group are –
Poor eating habits
Sitting for long hours at a stretch
More Exercise = Healthier Heart? Not Always
An unhealthy lifestyle leading to heart damage is digestible, however, what explains fit, healthy people having fatal heart attacks while exercising, notably in the cases of actors like Sidharth Shukla and Puneeth Rajkumar?
While exercise is vital for heart health and overall health in general, Dr Rastogi says overdoing it can do more harm than good sometimes, especially when you have hidden risks of heart damage.
"We have been doing a lot of thinking on this, and what we have found is that heart attack occurs in a prior disease which is present in the heart and people who were not aware of it were exercising as usual," he says.
"They were doing what they thought was right for them and they didn't get it checked and they ended up having these problems which caught them unawares."Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute
These could be pre-existing blockages, some valve problem, or some cardiomyopathy type problem, he says.
These all predispose them to sudden cardiac arrests and sudden cardiac deaths.
However, he also goes on to add, "If you do it in moderation, exercise is very good, and you must do it. And we must do regular check-ups to find out how much exercise is healthy for us."
Heart Attack Linked to Air Pollution?
Although your lifestyle choices are a huge determinant, it's not all on you. High levels of air pollution can also be a contributing factor.
"Air pollution has a multifactorial effect on the heart. Not only are these pollutants directly toxic to the heart, but also they do not allow you to exercise and do things that are healthy for your heart."Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute
In fact, another study conducted in the US in 2021 found that fewer cases of heart attacks were reported during the COVID lockdowns when air pollution levels were at their lowest.
Indians are also genetically predisposed to having a higher risk of heart attacks.
Heart disease is the number one cause of mortality among Indians. And Indians account for nearly 60% of the world’s heart disease burden.
"The data from India per se is limited but Indians who have settled abroad in Singapore, America, or elsewhere in Europe; when they do their population studies, they find that Indians have more severe disease at a younger age and suffer from heart diseases ten years earlier than their western counterparts," says Dr Rastogi.
Protecting Yourself Against Heart Disease
Well, you can’t escape work stress, viruses, genetics, or pollution, but all is not completely lost.
You can slow the damage to your heart, and considerably lower your risk of having a heart attack with some tweaks to your lifestyle here and there.
"These heart problems occur in clusters – high blood pressure, sugar, obesity, sedentary lifestyle, they are all important to cause these blockages to build up and then lead to a heart attack," says Dr Rastogi.
"After the age of 35 - 40 years, I recommend that on a yearly basis, one should check blood pressure, sugar, cholesterol levels."Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute
"In terms of exercise, isotonic exercises like walking, swimming, jogging playing outdoor games, badminton, tennis, golf etc, are all very healthy habits," he adds.
Dr Rastogi also talks about stress and how it needs to be checked because "once the heart attack occurs, even if you survive it, the heart gets damaged, and you end up having a lot of problems in your future life."
(The article is being republished from the Quint archives in light of the recent event of actor Nitesh Pandey's demise.)