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Producer Raj Kaushal's Death:Exploring the Epidemic of Heart Attack in the Young

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Indian Filmmaker Raj Kaushal, husband to Actor Mandira Bedi, died of cardiac arrest on 30 June after suffering a heart attack.

The producer was only 49 years of age at the time and is said to have experienced some discomfort in his chest the night before.

According to his close friend, music director, Suleiman Merchant, Raj Kaushal had experienced a heart attack once before in his early thirties.

What is causing the alarming epidemic of heart attacks in the young?

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Heart Attacks No More an Old Person's Problem

"Age is considered one of the non modifyable risk factors of heart problems," says Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute.

"Like somebody who has high blood pressure, the arteries will start to harden up and as they harden up, they become more prone to crack up. So, you know, strokes and heart attacks, they occur more frequently in those people who are of older age, because their their systems, their heart and other organs are exposed to a lot of risk factors for a longer duration of time."
Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute

But what was traditionally thought to be an 'old age' problem is fast turning into a silent epidemic among the young and (seemingly) healthy.

"This is a problem of the new millennium," says Dr Rastogi. "this problem was not there earlier, but now, we are very frequently seeing heart attacks in those who are very, very young. In fact, even in those in their early 20s or 30s."

He further speaks of how younger people are also more likely to have heart attacks as the first presentation of (cardiovascular diseases) CVD.

Older people, on the other hand, are more likely to experience, the relatively harmless, stable angina first as a warning sign.

"Heart attack is a very ominous problem in which suddenly there is a block in the in the arteries that leads to clot formation at that particular point, which stops the blood flow to the heart to the area of the heart. This leads to damage of the that area of the heart. And usually that is permanent unless until the artery is opened then in there."
Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute

'Hustle Culture Is Killing Us': Causes of Heart Attacks in the Young

According to a study conducted by the Trinity Hospital in 2013, everyday 900 Indians under the age of 30 die of heart attack.

What is causing this alarming rise in heart attacks among the young? Dr Rastogi lists a few notable reasons.

  • Lifestyle

It is no shocker that an increasingly sedentary lifestyle is to blame for the rise of NCDs (Non communicable diseases) often called 'lifestyle diseases' in younger people. Poor eating habits, smoking, bad posture, sitting for long hours at a stretch are all part of the problem.

High levels of air pollution can also be a contributing factor.

  • The Hustle culture

Dr Rastogi speaks of the high levels of stress that comes with 'hustle culture' that most young people get caught in–often at the cost of their health and welbeing.

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"The emphasis is more on slogging–working, studying or whatever. Young people don't exercise. Its only when they're established in their lives and careers that they think of exercising and adopting a hobby, but in their 'prime years' they're mostly slogging away, studying or working towards whatever they're trying to achieve in their life."
Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute
  • Genetic reasons

Another possible contrubtor is genes.

"These include problems like hereditary hypercholesterolemia wherein, because of the genetic factors the cholesterol is so high that the arteries become clogged with fat fatty tissues," explains Dr Rastogi.

Are Indians More Prone to Heart Conditions?

In fact, numerous studies have pointed to Indians being at a higher risk of developing cardiovascular diseases than others.

"Indians have heart attacks 10 years sooner than their western counterparts, they have more diffuse blockages of the arteries and they have very small arteries as compared to the latter."
Dr Vishal Rastogi, Additional Director, Cardiac Sciences, Fortis Escorts Heart Institute

Apart from genetic factors, Indians are also more prone to have diabietes which a contributing factor, he says.

Early Signs to Look Out For

A major reason for heart attacks at a young age, according to Dr Rastogi, is ignoring unlikely signs that many tend to brush off. These include,

  • Diffused, dull chest pain

  • Heaviness and pressure in the chest or upper stomach

  • Pain or discomfort in the jaw

  • Sudden sweating

  • Shortness of breath or feeling of obstruction in the chest

  • Retrosternal–behind the breast bone–burning that may be mistaken for acidity.

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Speaking to FIT about this for previous article, Dr Atul Mathur, Director, Interventional cardiology, Fortis Escort Heart Institute said,

“The looks of a person can be very deceptive. We have lots of patients who are very lean and thin and lead a very active lifestyle. But if they have any of the risk factors – family history, diabetes, high blood pressure, or they are smokers – they are still at risk of having a heart attack.”
Dr Atul Mathur, Director, Interventional cardiology

This is also the reason that some patients who present with early symptoms are often turned away even by physicians.

"In fact, once they go to the physician also, because of their age, the suspicion is not there that they've got a heart disease. Usually people just take the easy route, check the blood pressure and write it off as gas and prescribe acidity medication," says Dr Rastogi.

"This is how it gets neglected until the disease has progressed to a later stage," he adds.

Measures to Help Prevent Heart Disease

  • Exercise regularly: Dr Rastogi recommends walking 45 minutes a day, at least five days a week, or engaging in some outdoor sport.

  • For those with desk jobs, its important to stand, and walk around from time to time.

  • Reduce fatty food and carbohydrates, and increase fibre, protein and fruit intake.

  • Get routine check ups: For those in their 20s, it is sufficient to get this done once in 5 years. Once you cross 40, annual check ups are recommended.

  • Find ways to reduce stress: Avoid being hyperfocued on work, find a work life balance, indulge in hobbies, and other leisure activities when you can.

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