Heart disease striking Indians decades early: Doctors flag diet, stress, pollution and genetics
Heart disease is increasingly being detected among younger Indians, with doctors pointing to a combination of genetic vulnerability, unhealthy diets, smoking, sedentary lifestyles, chronic stress and air pollution as major factors driving cardiovascular risk decades earlier than in the past.
Dr Sanjay Chugh, Director, Cardiology at Aakash Healthcare, said doctors are witnessing not only a rise in heart disease but also its earlier onset.
“We are not just seeing more heart disease – we are seeing it arrive decades ahead of schedule,” Chugh said.
He attributed the trend to a combination of unhealthy eating habits, or what he referred to as “Tamasik Bhojan”, smoking and alcohol consumption, lack of exercise, chronic stress, environmental pollution including air pollution exposure, and an underlying genetic or family vulnerability.
According to Chugh, Indian populations are more prone to metabolic syndrome X and coronary disease, including heart attacks, compared with Western populations.
“This is not a problem we can treat our way out of once patients are already on the table,” he said, stressing the need for preventive healthcare much earlier in life.
“We need people walking into a hospital or clinic in their 20s asking for a heart check-up the same way they would ask for an eye test. That is the culture shift India actually needs,” Chugh said.
Dr LK Jha, Associate Director and Head Unit-II, Cardiology at Asian Hospital, also identified genetics as a key factor while pointing to lifestyle changes behind the rise in cardiovascular disease among younger people.
“Genetics is a key factor. In addition, due to various lifestyle factors, we are seeing a rise in cardiovascular diseases even among the youth,” Jha said.
He said Indians tend to have lower levels of protective HDL cholesterol, higher rates of type 2 diabetes, more abdominal fat and a greater tendency towards high blood pressure compared with Western populations.
Jha said this underlying vulnerability is now interacting with changing food habits, including greater consumption of packaged foods and trans-fat-heavy street food, which he said increases cardiovascular risk.
Smoking is adding to the burden among younger Indians, he said, particularly with the growing use of vapes and flavoured tobacco.
According to Jha, smoking damages the lining of blood vessels and accelerates the narrowing process associated with cardiovascular disease, contributing to its appearance at younger ages.
Dr Rajendra Patil, Consultant – Cardiology at Jupiter Hospital, also warned about the role of trans fats in cardiovascular disease.
“Trans fats in particular are strongly linked to heart attacks and strokes,” Patil said, adding that many people consuming such foods several times a day may not know what their food contains.
He also pointed to increasingly sedentary routines as another contributor to the problem. Long commutes, desk-based jobs and screen-heavy leisure activities have reduced physical activity among millions of young Indians, including people who consider themselves otherwise healthy.
The concerns, doctors said, extend beyond cardiology, with chronic stress, poor sleep, inactivity and pollution affecting other areas of health and potentially appearing as early warning signs of cardiovascular problems.
Dr Vineet Malhotra, Head of Urology at VNA Hospital, said he is seeing more men in their late 20s and early 30s with erectile dysfunction linked to early vascular disease.
“The blood vessels involved in sexual function and the ones feeding the heart are built the same way,” Malhotra said.
“When a young man comes to us with this complaint, we don't just treat the symptom. We send him for a cardiac workup, because often this is the first sign, not the heart attack itself,” he added.
For women, Dr Archana Dhawan Bajaj, Founder and Director of The Nurture IVF Centre and a gynaecologist, said cardiovascular risk can be harder to identify because heart disease in women is frequently missed.
She noted that symptoms can present differently in women and that public awareness around heart disease remains disproportionately focused on men.
Bajaj also pointed to the sharp rise in polycystic ovary syndrome (PCOS) among young urban women, saying it could leave a section of the population accumulating cardiovascular risk without adequate screening.
Across specialities, the doctors' recommendations converge on shifting the focus from treating established heart disease to identifying cardiovascular risk earlier.
They advocate cholesterol and blood pressure checks from the 20s rather than waiting until the 40s, greater attention to chronic workplace stress, and recognition of air pollution as a cardiovascular concern in addition to its established respiratory impact.
Dr Praveen Gupta, Chairman - Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals said "People generally believe heart disease and brain disease are two separate conversations. However, it is important to understand that they share the same blood vessels. When we see arteries narrowing in someone's heart in their early 30s, the same process is quietly happening in the vessels feeding the brain -- it is just less visible until something goes wrong.
However, it may not announce itself as dramatically as a heart attack. It can show up first as brain fog, poor concentration, or unexplained fatigue -- symptoms young professionals often brush off as burnout or stress. Apart from stress, poor sleep and sedentary habits also have a silent impact on the brain's blood supply, one that builds up quietly over years without any visible symptom. We are increasingly asking patients about their cardiac history when they come in with cognitive complaints, because the two are far more connected than people realise. Chronic stress, disrupted sleep, high blood pressure -- these don't just strain the heart, they strain the brain's blood supply too. By the time someone actually has a cardiac event, in many cases their brain has already been under silent stress for years."