"In such cases, an underlying condition of uncontrolled heart rate, weak heart chambers or problematic arteries gets aggravated because of sedentary lifestyle, obesity, inactivity, smoking or high-fat diets," said Dr Neeraj Bhalla, chairman, department of cardiology at BL Kapoor Super Specialty Hospital, where 60% people treated for a heart attack are under 65 years.
"The first heart attack often kills because people are not aware that they have heart disease," he adds.
Once you hit 40, everyone needs an annual health check-up with an emphasis on blood sugar levels, lipids and blood pressure. Even if one of your parameters is uncontrolled, repeat the lipid profile twice a year till they stabilise.
Though the female hormone oestrogen protects young women against heart trouble, higher levels of hypertension and diabetes make them lose this advantage from the age of 40 years.
Surjeet Kaur, 56, was in a kitty party when she had a heart attack. She was feeling uneasy and knew that something was not right, but couldn't imagine it could be a heart attack.
"I felt terribly sick. My chest hurt and I was sweating profusely. A friend who had suffered an attack quickly put a sorbitrate under my tongue, as she probably guessed that it was more than just pain," says Kaur.
Standing at 5' 1'', Kaur weighs 84 kg, her blood pressure is high and sugar uncontrolled, ranging between 200 and 300 mg/Dl.
"Usually, obesity, diabetes and high blood pressure are too blame, all of which increase risk of a heart attack," says Dr S. Padmawati, chairman, National Heart Institute.
Women also have more atypical symptoms.
"They may have abdominal pain, tiredness and vomiting," she adds.
Women who are on the contraceptive pill and smoke are at a much higher risk.
"In the last 20 years, the cases in women have gone up by over 200 times. Change in lifestyle, obesity, stress, early menopause and several other factors have behind this. The average age of women showing up with cardiac ailments has also gone down by 10 years- earlier it was 65- now 55," said Dr Ashok Seth, chairman, Fortis Escorts Heart and Research Institute.
Getting active and having a healthy weight is a good way to protect your heart. A study of 4,000 heart patients in their 40s and 50s showed that even those who switched to 2.5 hours of weekly exercise benefitted tremendously.
"Indians are genetically more vulnerable to heart problems. If we studied our lipids closely, we usually have moderate LDLs (good cholesterol) but high triglycerides, a type of blood fat," says Dr Anil Dhal, director of cardiology, Delhi Heart and Lung Institute.