Heart Disease Is Striking Indians Earlier — Doctors Point to Diet, Stress, Pollution and Genetics

Heart disease is increasingly being detected among younger Indians, with doctors warning that a combination of genetic susceptibility and changing lifestyles may be bringing cardiovascular problems forward by decades.

Doctors say unhealthy diets, smoking, alcohol consumption, physical inactivity, chronic stress, poor sleep and prolonged exposure to air pollution are contributing to cardiovascular risk among younger adults. An underlying family history and metabolic vulnerability may further compound that risk.

Dr Sanjay Chugh, Director, Cardiology at Aakash Healthcare, said clinicians are seeing both a higher burden of heart disease and an earlier age of 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 several interacting factors, including unhealthy eating habits, smoking and alcohol use, inadequate exercise, chronic stress, environmental pollution and genetic or family predisposition.

Chugh said Indian populations may be particularly vulnerable to metabolic syndrome and coronary artery disease compared with Western populations, highlighting the need for prevention well before symptoms appear.

“This is not a problem we can treat our way out of once patients are already on the table,” he said.

He called for a shift towards earlier cardiovascular screening, arguing that people in their 20s should become more comfortable discussing heart health with doctors.

“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.

Genetics meets changing lifestyles

Dr LK Jha, Associate Director and Head Unit-II, Cardiology at Asian Hospital, also highlighted genetics as an important component of cardiovascular risk, but said lifestyle changes are increasingly adding to that underlying vulnerability.

“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.

According to Jha, Indians can have several metabolic risk factors, including lower levels of protective HDL cholesterol, higher rates of type 2 diabetes, greater abdominal fat and a tendency towards high blood pressure.

He said these vulnerabilities are increasingly interacting with changing dietary patterns, including greater consumption of packaged foods and foods containing trans fats.

Smoking is another concern, particularly among younger people, Jha said, pointing to cigarettes as well as newer tobacco products and vaping.

Smoking can damage the inner lining of blood vessels and contribute to processes that narrow and stiffen arteries, potentially increasing cardiovascular risk over time.

Trans fats, inactivity add to the burden

Dr Rajendra Patil, Consultant – Cardiology at Jupiter Hospital, warned about the cardiovascular risks associated with trans fats.

“Trans fats in particular are strongly linked to heart attacks and strokes,” Patil said.

He noted that people may consume foods containing such fats repeatedly without knowing their nutritional composition, particularly when eating processed or commercially prepared foods.

Physical inactivity is another growing concern. Long commutes, desk-based employment and screen-heavy leisure time have reduced opportunities for movement among many young adults.

The result, doctors say, is that someone can appear outwardly healthy while accumulating several cardiovascular risk factors, including excess weight, high blood pressure, abnormal cholesterol and impaired glucose metabolism.

When sexual health becomes a cardiovascular warning

The potential link between vascular health and other seemingly unrelated symptoms is also drawing attention.

Dr Vineet Malhotra, Head of Urology at VNA Hospital, said he is seeing men in their late 20s and early 30s with erectile dysfunction associated with 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.

The underlying message, doctors say, is that vascular problems can sometimes become apparent through symptoms outside the heart itself.

Heart health can look different in women

For women, identifying cardiovascular risk can be more complicated because symptoms may differ from the classic presentation many people associate with heart attacks.

Dr Archana Dhawan Bajaj, Founder and Director of The Nurture IVF Centre and a gynaecologist, said heart disease in women can be overlooked, while public awareness continues to focus heavily on male patients.

She also pointed to the increasing prevalence of polycystic ovary syndrome (PCOS) among young urban women, noting that associated metabolic factors may contribute to cardiovascular risk and warrant appropriate monitoring.

The heart-brain connection

Doctors are also drawing attention to the connection between cardiovascular and brain health.

Dr Praveen Gupta, Chairman, Marengo Asia International Institute of Neuro and Spine (MAIINS), Marengo Asia Hospitals, said diseases affecting blood vessels can have implications for both the heart and brain.

“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,” Gupta said.

He said narrowing of arteries can affect circulation to multiple organs, while factors such as high blood pressure, chronic stress, poor sleep and sedentary habits can affect vascular health over time.

According to Gupta, some people may experience less specific symptoms such as difficulty concentrating or persistent fatigue, which can easily be attributed to stress or burnout.

“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,” he said.

Doctors call for earlier prevention

Across specialties, the doctors emphasise a common shift: cardiovascular health needs attention before established disease develops.

That means paying attention earlier to blood pressure, cholesterol, blood sugar, weight, smoking, physical activity, sleep, diet and family history rather than waiting for symptoms or a cardiac event.

They also argue that air pollution and chronic psychological stress deserve greater consideration as part of the broader cardiovascular-risk conversation.

The message is not that every young Indian is destined to develop heart disease. Rather, doctors say the combination of inherited susceptibility and modifiable risk factors makes early prevention increasingly important.

For younger adults, recognising risk factors early—and discussing appropriate screening with a healthcare professional—could help identify problems before they progress to a major cardiovascular event.