Nitesh Pandey heart attack death: Why Indian men in their 50s are most at risk of sudden cardiac arrest

According to Dr Mohammed Rehan Sayeed, Consultant, Cardiovascular And Thoracic Surgery, Manipal Hospital, Bengaluru, “The most important factor is genetic predisposition – Studies have shown that Indians are genetically predisposed to developing cardiac problems at least by a decade earlier than their Western counterparts. Generally cardiac problems in Indian adults begin to develop in the early to mid-40s and hence they are at a greater risk of experiencing angina or cardiac arrest. Indians are also genetically predisposed to hoard the bad cholesterol (LDL and triglycerides) in their body. The cause for this bad cholesterol hoarding is majorly attributed to certain enzymatic deficiency and not dietary habits. LDL and triglycerides are bad for the heart as they increase the risk of CADs.”

He even lists diabetes as a risk accelerator. As per recent statistics, India has about 77 million people above the age of 18 years living with diabetes. About 25 million are prediabetics which means they are at a great risk of developing diabetes in near future, and an alarming percentage of people are unaware of their diabetes status.

Then there are lifestyle factors and hypertension. “A vast majority of the population has a sedentary and unhealthy lifestyle from a very young age which again puts them at a risk of many health issues and hidden cardiac problems. Any sudden changes such as starting vigorous physical activities such as HIIT (high intensity interval training) and gymming may exacerbate the hidden cardiac conditions and lead to cardiac arrests,” says Dr Sayeed.

What triggers sudden cardiac arrests and death and why are men more vulnerable than women?

The triglycerides and LDL cholesterol accumulate within the blood vessels and form hard deposits within the arteries, which are known as atherosclerotic plaques. “These plaques have a tendency to dislodge whenever there is a sudden load or stress on the arteries. The dislodgement can be triggered by any kind of physical or emotional stress. The dislodged plaques cause blockage in the arteries and lead to SCA and death,” he says.

In general, SCAs are more common in men than in women because, explains Dr Sayeed, “the female hormone, estrogen, has potent cardiac protective properties due to which women are at a significantly lower risk of having cardiac arrests until the perimenopause and menopause age. After menopause, there is no major difference between men and women.”

What are the signs and symptoms to look out for?

There are no standard signs and symptoms that may help you identify the early signs of CAD. “The signs are often very vague or non-specific and may even get masked with symptoms related to other problems such as acidity, epigastric pain, mild discomfort in the chest, or jaw pain,” adds Dr Sayeed.

Precautions and medical tests that help determine if you are at risk of CAD

A normal ECG may not be very effective in determining the CAD status. “A CT-coronary angiogram showing low calcium score and less than 30 per cent blockages is an indication of low or minimal risk of CAD. Also, determining your diabetes status (HbA1C is more reliable than the routine FBS and RBS test) and seeking medical treatment is one of the best ways to keep CADs at bay. Furthermore, if there is a family history of cardiac problems, it is highly recommended that you undergo regular master health check-ups,” he says.

Since incidence of cardiac diseases increases with age, it becomes important for people in their 40s and 50s to be on guard. “It would be prudent not to ignore symptoms such as chest pain, shortness of breath, palpitations, and episodes of near or total loss of consciousness and to seek immediate medical help. It is highly recommended to do routine check-ups for cardiac risk factors such as diabetes, high blood pressure and high cholesterol and discipline oneself to follow a pattern of moderate intensity exercise consistently. Stress and weight management should be done mandatorily. If you have been used to consuming alcohol and smoking, then one immediately needs to limit the intake post mid-40s,” says Dr Nagarajan.

“Eating in moderation and dividing the large portion meals into small-sized ones (about six a day) may help you maintain your metabolism. Also you can follow a 14:10 rule of intermittent fasting to manage weight. It is important to note that if you have not been exercising regularly or if you have been sedentary for long, you will have to gradually increase your exercises and workout regimes rather than diving in straight,” advises Dr Sayeed.