Heart Attacks No Longer A Disease Of Age: Why Indians In Their 20s And 30s Are Increasingly At Risk

The sudden death of celebrated shooting coach and former Asian Games champion Jaspal Rana at the age of 49 recently has once again drawn attention to a disturbing trend: heart attacks are increasingly striking younger Indians. Rana reportedly suffered a heart attack that went unrecognised for days before he was hospitalised, eventually succumbing to cardiac complications despite treatment.

His death is not an isolated incident. Over the past few years, several seemingly healthy public figures, including actor Sidharth Shukla, who died at 40, and Kannada superstar Puneeth Rajkumar, who died at 46, have highlighted how cardiovascular disease is no longer confined to old age. Doctors say they are now seeing heart attacks in individuals in their 20s and 30s, many of whom do not fit the traditional image of a cardiac patient.

For decades, heart attacks were considered a disease of middle and old age. A sedentary 60-year-old smoker with diabetes was often seen as the typical cardiac patient. That image is rapidly changing.

Today, cardiologists across India are reporting an increasing number of heart attacks among people in their 20s, 30s and early 40s — individuals who are professionally active, physically fit and often outwardly healthy.

The shift has triggered concern among doctors, who say a combination of stress, unhealthy lifestyles, genetic predisposition and metabolic disorders is pushing cardiovascular disease into much younger age groups.

The trend is particularly alarming because many young adults do not consider themselves vulnerable to heart disease and often ignore early warning signs.

Fitness is not always protection. Dr. Vanita Arora, Clinical Lead – Cardiac Electrophysiology, Senior Consultant Interventional Cardiologist & Cardiac Electrophysiologist, Indraprastha Apollo Hospital, Delhi, said the perception that exercise alone can protect an individual from heart disease is misleading.

"A fit lifestyle, if it means a gym lifestyle, doesn't go with that because even if you are exercising well, if you are stressed, you have tension, you have a lot going on in your life, your eating habits are not good, you don't have time to relax and you have a genetic history, which means your family history for heart disease, then you are not totally safe against heart attacks."

According to her, the growing burden of stress among younger adults is emerging as a major contributor to early-onset heart disease.

"Early heart attack onset is occurring because of these reasons. They are happening in young people because it's young people who are undergoing a lot of stress, balancing their work, home life and at the workplace, they have a lot of stress, stress is the biggest risk factor for heart attack."

Modern lifestyles have altered traditional cardiovascular risk profiles. Long working hours, irregular sleep schedules, processed food consumption, reduced physical activity and constant connectivity have created conditions that can accelerate the development of heart disease.

Dr. Arora said routine screening should now begin much earlier than previously recommended.

"Another thing is that you know youngsters, in case they do not get their checkup done; earlier we used to say that checkup has to be done from the age of 40, but now we say 25-30 people also should get their checkup done so that they are diagnosed early in case they have coronary artery disease which causes heart attacks. So, the general checkup prevention can be done by a general checkup of the heart, which should be done on a yearly basis."

The situation is particularly worrying in India, where cardiovascular disease tends to occur earlier than in many Western countries.

Dr. (Prof.) Tarun Kumar, Director and Head, Medanta Moolchand Heart Center, said Indians face a unique vulnerability.

"Indians face a unique and aggressive risk of heart disease, developing cardiac complications 5 to 10 years earlier than Western counterparts. Strikingly, 50% of all heart attacks in Indian men occur under the age of 50, and 25% occur under the age of 40."

He attributed the phenomenon to a combination of biological and environmental factors.

"Factors responsible are high Lipoprotein A and dyslipidaemia, genetic tendencies, hypertension, early-onset diabetes, obesity, stress, high incidence of tobacco consumption, sedentary lifestyle, high-fat and calorie-rich diet and, last but not least, ever-spreading pollution."

Dr. Kapil Khanna, Consultant Cardio-Physician, Yashoda Medicity Hospital, Indirapuram, Ghaziabad, echoed similar views, saying doctors are witnessing a clear shift in the age profile of heart attack patients.

"For too long, heart attacks have been considered a disease of older people. That is no longer the case. Increasingly, we are seeing myocardial infarctions in adults in their 20s, 30s and 40s."

He explained that the causes are largely linked to modern lifestyles. "The causes are familiar: chronic stress, poor sleep, diets high in processed and sugary foods, smoking or vaping, obesity, diabetes, high blood pressure, and sedentary lifestyles. Genetics can raise risk, but lifestyle usually determines when that risk manifests."

One of the biggest dangers, he said, is delayed treatment.

"A major danger is that young people often ignore warning signs. A heart attack does not always present as dramatic chest pain. It can begin as unusual fatigue, shortness of breath, heartburn-like discomfort, pain in the jaw, neck, back or arm, nausea, cold sweats, or palpitations. These symptoms are frequently dismissed as acidity, anxiety, or overwork, delaying urgent care."

He stressed that timely treatment can save lives.

"Time is critical. When a coronary artery is blocked, every minute counts. Seeking medical attention within the first 90 minutes significantly improves survival and reduces long-term heart damage; delays of hours or days can be fatal."

Dr. L.K. Jha, Associate Director & Head Unit II, Cardiology Department, Asian Hospital Faridabad, said the increasing incidence of heart attacks among young Indians should serve as a national wake-up call.

"In India, heart attacks are on the rise among the younger age group, and it is a cause of concern. Until a few years back, heart disease was thought to be a problem of older age, but we are now seeing cases in people in their 30s and even 20s."

He added: "It is mainly due to unhealthy lifestyles, lack of physical activity, long working hours, stress, poor sleep, smoking and increasing consumption of processed and fast foods. Conditions like obesity, diabetes, high blood pressure and high cholesterol are also visible at younger ages. Often adding to the risk is a family history of heart disease."

Many heart attacks can still be prevented through a healthy lifestyle and early screening, Dr. Jha said, warning that the rising number of cardiac emergencies and sudden deaths among young adults shows that heart disease is now striking much earlier, often without warning, and can be deadly if risk factors go unnoticed.