One in every two people feels that the time to start worrying about heart diseases is after turning 30 years or even later, a survey of 4,000 people by the World Heart Federation in India, Brazil, the United Kingdom and the United States of America has found.
They, however, couldn’t be more wrong. The risk of a heart disease begins developing even before you are born. But an active and healthy life reverses the risk almost completely. Around 15% of the people who show up at the Fortis Heart Institute and Medanta’s High Command Centre are aged below 30 years, a number that has gone up three times over the past decade.
Currently, stroke and heart diseases are the world’s leading causes of death, killing 17.3 million each year. One in three deaths in India is caused by heart disease.
Heart diseases almost never strike children, unless, of course, they are born with an inherited heart or blood-vessel defect. But the preventable risk of it affecting you sooner than later begins in the womb and looms large over every stage of your life.
“Although heart diseases are typically diagnosed in adults, its roots begin in childhood. More than one study have shown that plaque (fatty deposits inside the artery walls that clog it and overwork the heart) begins building up very early in life, even in children as young as five-year-olds,” says Dr Upendra Kaul, executive director of cardiology at Fortis Escorts Heart Institute.
High and low of birthweight
The first factor that affects your heart is your birthweight. According to the Barker hypothesis, children born with low birthweight (less than 2.5 kg) who rapidly gain weight after two years of age are at risk of hypertension, stroke and Type 2 diabetes. This Fetal Origins theory shows that undernutrition in the womb permanently changes the body’s metabolism and physiology.
Restricted growth in the womb increases appetite-producing neuropeptides in the brain’s hypothalamus — the central control of the appetite — which increases the natural tendency of these children to eat more, reported the Journal of Neuroscience Research last week.
“Foetal undernourishment is more common than believed, not because of chronic malnourishment but also because mothers-to-be may be eating food deficit in nutrients, or because they are too thin or overweight,” says Dr Ravi Kasliwal, chairman, clinical and preventive cardiology, Medanta-The Medicity. In India, two in three babies are born underweight. It can be prevented by mothers eating healthy and ensuring their toddlers, irrespective of their birthweight, stay lean and active.
Trouble starts if the baby puts on weight. Two out of three obese two to 18-year-olds have at least one risk factor for heart disease, such as high cholesterol, high blood glucose levels or high blood pressure, reported Dutch researchers in Archives of Disease in Childhood in July this year. Excess weight also makes them three to five times more likely to suffer heart attacks or strokes before they reach 65 years of age than children with a healthy weight.
“Low birthweight coupled with rapid weight gain in the first few years of life raises the risk of metabolic syndrome, which is a term used to describe a group of food- and inactivity-related disorders that raises chances of heart disease and stroke later in life, especially among smokers and obese, inactive people,” says Kasliwal.
Control, control, control
The first signs of weight gain, high blood pressure and high cholesterol, especially if you are inactive and a smoker, should be a red flag. “Roughly half of all heart attacks and strokes come out of the blue in people with no diagnosed heart disease, so identifying risk factors early is a must to delay disease and prevent death,” says Dr Kasliwal.
One in two Indian smokers don’t know smoking causes stroke, while 38% — more than one in three — don’t know it causes heart disease, shows data from the Indian Heart Watch, the country’s largest ever heart risk survey of 6,000 men and women from 11 cities.
“Unless risk factors such as blood pressure, cholesterol levels, diabetes, weight and smoking are actively tracked throughout life, lifestyle changes alone are often not enough to control disease. If blood pressure and cholesterol remain high despite lifestyle changes, blood-thinners like low-dose aspirin and cholesterol-lowering statins should be prescribed aggressively to lower risk,” says Dr Kaul.
A study in The Lancet earlier this year found statins reduce the risk of heart attack and stroke even in people with no diagnosed heart disease by a fifth.
At the end, it is how you live your life before and after the diagnosis. “Avoiding animal fats found in meats, butter and eggs, eating high-fibre food, controlling weight and staying active should be your way of life and not something you do after being diagnosed with heart problems,” says Dr Kaul.