Young, Urban and at Risk: The Silent Epidemic of Early Heart Disease

By Dr. Chirag D, Consultant-Interventional Cardiologist, Aster Whitefield Hospital

Until recently, heart attacks were considered an “older person’s” disease. But cardiologists across India are sounding the alarm: they’re now seeing heart attacks and serious heart ailments in people barely into their thirties — and sometimes even in their twenties.

“In my practice, we’ve definitely seen an increase,” says Dr. Chirag D, Consultant, Interventional Cardiology, Aster Whitefield. “Compared to a decade ago, the incidence of heart attacks in the 30–40 age group has risen by about 30–40%. Most present mild-to-moderate heart attacks, but some arrive with major events.”

What’s driving this shift?

The biggest culprit is no mystery:

lifestyle. Long, irregular work hours, the “always online” work-from-home culture and little structured exercise are creating a sedentary, stressed population whose cardiovascular fitness is steadily declining. When you add in easy access to high-calorie fast food and processed snacks, the recipe for high blood pressure, abnormal cholesterol and early artery changes is complete.

Furthermore, there has been an increase in smoking in young adults and passive exposure at home, cafes, and common areas. Tobacco is the most important modifiable risk factor for coronary artery disease, promoting plaque buildup, increasing clotting risk, and blunting the effects of healthy diet or exercise.

Finally, pollution may be an unrecognized co-sinner. To date, scientists are still determining how much air pollution is a direct trigger of heart attacks but there is evidence that fine particulate matter (PM2.5) and the effects of long-term air pollution exposure leads to increased inflammation and arterial stiffness, indirectly increasing heart risk.

The good news? All three drivers are modifiable. Building daily movement into work routines, choosing fresh foods over packaged, quitting smoking and minimising exposure to polluted air where possible can meaningfully reduce heart-attack risk, even for people in their 30s and 40s.

Are women affected too?

Historically, premenopausal women had a lower risk of coronary artery disease (CAD) than men of the same age, thanks largely to the protective effects of estrogen on blood vessels, lipid profiles, and inflammation control. But that protective wall seems to be thinning. Doctors are now seeing more cases of CAD in younger women, even those still menstruating, signaling that the gender gap in heart risk is narrowing.

Multiple studies confirm this trend. In India, a growing percentage of women under 45 present with acute myocardial infarction, with research showing 25–40% of Indian women with heart attacks are younger than 45.

Data from around the world indicate that events of heart disease in women aged 35–54 are rising. For instance, the number of heart attacks in women ages 35 to 54 went up to 31% from 21% in 1995 to the year 2014. Obesity, diabetes, hypertension, smoking, poor eating habits, and physical inactivity are risk factors that contributed to this change, along with those that went beyond previous definitions of estrogen/hormonal protection. Further, the changing hormonal environment of perimenopause can advance changes in cholesterol and blood pressure prior to a sequential menstruation.

Women and doctors must no longer assume youth or menstruation means “safe.” Vigilance, early screening and managing cardiovascular risk factors are vital — now more than ever.

What young people can do to protect their hearts

Cardiologists stress that four everyday habits dramatically cut heart-attack risk even in your 30s and 40s.

Regular movement—at least 30–45 minutes of brisk walking or moderate exercise most days—improves vessel flexibility, lowers blood pressure and keeps blood sugar in check. Short bouts across the day still help.

A balanced diet- A diet that is high in vegetables, fruits, whole grains and lean proteins, and low in salt, sugar and trans fats results in lower cholesterol levels and less inflammation. Small substitutions in the diet (grilled instead of fried, brown rice instead of white rice, etc.) also have an additive effect.

Quitting smoking – either actively or passively – is the single most powerful action you can take; it can have an immediate effect on slowing deterioration of the arteries and risk of clotting.

Routine regular screening for blood pressure, cholesterol and blood sugar will allow us to catch silent problems early when it is easiest to reverse. cardiologists say the trick is not a gimmick but a wise lifestyle choice, and together these simple changes can delay or even prevent heart disease. This is particularly important given the rising risk of cardiac disease among India's younger workforce. 

The bottom line

India’s young workforce is facing a heart health crisis driven by lifestyle, smoking and possibly environmental factors. But heart attacks are not inevitable. By adopting healthy daily habits and undergoing regular screening, even busy professionals can drastically reduce their risk. As the cardiologist puts it: “Simple changes — consistent exercise, mindful eating, quitting smoking and periodic checks — can keep heart attacks at bay, no matter how old you are.”