32-year-old man with two stents says heart attacks know no age: ‘Don’t miss out on this particular test’

But how much of this advice holds up medically? Dr Anup Taksande, Clinical Director – Cardiology and Cardiac Interventions, KIMS Hospitals, Thane, explains what people should know.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.

Looking fit does not mean your arteries are healthy

According to Dr Taksande, a common misconception is that someone who exercises regularly and has no symptoms must have healthy arteries.

“Heart disease doesn’t always give warning signs,” he said. Conditions such as high blood pressure, diabetes and abnormal cholesterol can remain undetected for years. Genetics can also influence cardiovascular risk, particularly when there is a family history of heart attack or stroke at a young age.

“Fitness can be seen while risk is generally not visible,” Dr Taksande explained.

For most adults, he said, it is more useful to track basic health measurements than to undergo multiple tests without a clear reason. These include blood pressure, blood sugar or HbA1c, and a lipid profile.

These checks should begin in early adulthood, with the frequency depending on a person’s age and individual risk factors. People with symptoms, several cardiovascular risk factors or a strong family history may need a more detailed evaluation.

“ECGs, stress tests, echocardiography or coronary calcium scans can be useful” in certain people, Dr Taksande said, but these should not automatically be treated as routine tests for every healthy adult.

“The appropriate test is the one which provides an answer to a significant clinical question,” he added.

The Phase 1b Heart-2 trial involved 35 participants with inherited cholesterol disorder or premature coronary artery disease. (Source: Pexels)

What is Lipoprotein(a)?

One of Biswas’ key recommendations was getting Lp(a) tested. Dr Taksande said this is worth knowing because it represents a cardiovascular risk factor largely determined by genetics.

“Lp(a), or lipoprotein(a), is a particle which carries cholesterol and the amount of it is mostly inherited,” he said. Unlike several conventional cardiovascular risk factors, lifestyle changes have only a limited effect on the amount of Lp(a) produced by the body.

Elevated Lp(a) can increase the risk of plaque formation and cardiovascular events, including premature heart attack and stroke. It is also associated with calcific aortic valve disease.

Importantly, a person can have an apparently acceptable conventional cholesterol profile and still have elevated Lp(a).

“Present guidance on cardiovascular health recommends that Lp(a) should be measured at least once during adulthood,” Dr Taksande said, particularly in people with a family history of premature cardiovascular disease or cardiovascular disease that cannot be adequately explained by their usual risk factors.

Because Lp(a) levels are largely genetic and generally remain stable, repeated testing is usually unnecessary unless there is a specific clinical reason.

However, an elevated Lp(a) does not mean a heart attack is inevitable.

“It simply means that you should take the other risk factors which can be modified—particularly LDL cholesterol, blood pressure, diabetes, smoking, and lifestyle—much more seriously,” Dr Taksande said.

Should you cut out sugar and oil completely?

Biswas suggested reducing sugar and oil as two key dietary changes for better heart health. Dr Taksande, however, cautioned against reducing cardiovascular nutrition to a single ingredient.

“Nutrition topics are frequently made unnecessarily polarising,” he said, noting that describing sugar as a “poison” or presenting one cooking oil as universally harmful and another as universally protective oversimplifies nutrition.

Excessive sugar intake, particularly from sugary drinks and highly processed foods, can contribute to weight gain, insulin resistance, diabetes and high triglyceride levels. These factors can, in turn, increase cardiovascular risk.

Cooking oil also needs to be considered for both quality and quantity. Dr Taksande recommends limiting saturated and trans fats while favouring unsaturated fats. He also advises avoiding heating and reusing cooking oil.

“The heart doesn’t react to a single ingredient; rather, it reacts to the way our diet is patterned over a period of years,” he said.

Instead of searching for one “perfect” cooking oil, Dr Taksande recommends an overall eating pattern that includes vegetables, fruits, whole grains, pulses and nuts where appropriate, along with sufficient protein and a moderate amount of suitable cooking oil.

“For maintaining heart health, sticking to a moderate approach is generally better than adopting extreme dietary measures,” he said.

How much exercise do you need?

Biswas recommended 30 to 45 minutes of movement four to five times a week and suggested that people do not need to run marathons to protect their hearts.

Dr Taksande agrees that regular movement is an important part of cardiovascular prevention. Physical activity can improve blood pressure, insulin sensitivity, lipid profile, weight control and cardiorespiratory fitness.

Adults should generally aim for at least 150 minutes of moderate-intensity physical activity a week, along with appropriate muscle-strengthening activity.

This means that activities such as brisk walking can contribute meaningfully to the weekly target. The key is consistency rather than extreme exercise.

Sleep and stress matter, too

Biswas also emphasised getting seven to eight hours of sleep every night and incorporating stillness through breathing exercises or meditation.

Dr Taksande said these are not merely lifestyle extras. “They form part of cardiovascular prevention,” he said. For most adults, he recommends aiming for around 7 to 9 hours of good-quality sleep. Consistently getting too little sleep is associated with poorer metabolic and cardiovascular health.

DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.