Why young, slim Indians still get heart attacks
South Asians tend to have their first heart attack years earlier than people elsewhere, often at a normal body weight. Here's why, the warning signs, and the tests worth doing.
· 6 min read· 4 sources
Earlier, and at lower weights
The INTERHEART study compared heart attack patients across 52 countries. People in South Asia had their first heart attack at a median age of 53, compared with 58 in other countries. Most of that difference was explained by higher levels of common risk factors at younger ages, not by some mysterious cause.
South Asians also tend to develop diabetes and heart risk at lower body weights. That’s why the WHO recommends lower BMI cut-offs for Asian populations: a BMI of 23 or above already signals higher risk, compared with 25 for many other populations.
Slim isn’t the same as healthy
You can look slim and still have high blood sugar, high cholesterol, high blood pressure, or visceral fat around your organs. The American Heart Association’s statement on South Asians describes this pattern: more abdominal fat, more insulin resistance and more diabetes at a given body weight. Your heart responds to what’s in your blood vessels, not to how you look.
The risk factors that matter most
INTERHEART found that a small set of factors accounted for most heart attack risk:
- Abnormal cholesterol (lipids)
- Smoking, including other tobacco use
- High blood pressure
- Diabetes
- Abdominal obesity
- Psychosocial stress
- Low intake of fruit and vegetables
- Lack of regular physical activity
Every one of these can be measured, and most can be changed.
Warning signs — don’t wait
Chest pain, pressure or tightness; pain spreading to the arm, jaw, neck or back; breathlessness; cold sweat; nausea; or sudden unusual tiredness can all be signs of a heart attack. Women are more likely to have symptoms other than chest pain. If you think it could be a heart attack, call your local emergency number immediately — 112 in India and across Europe (108 for an ambulance in most Indian states), 911 in the US and Canada, 999 in the UK. Don’t wait to see if it passes, and don’t drive yourself.
In men, new erectile difficulty can be an early sign of blood vessel disease. A meta-analysis found it is linked to higher cardiovascular risk, so it’s worth mentioning to a doctor.
Know your numbers
Get a baseline in your 20s:
- Blood pressure, measured with a cuff
- Fasting blood sugar or HbA1c
- A lipid profile (cholesterol)
- Waist size
Repeat them as your doctor advises. Knowing these numbers, together with not smoking and staying active, are among the most useful things you can do for your heart in your 20s and 30s.
References
- 1.Risk factors for early myocardial infarction in South Asians compared with individuals in other countries (INTERHEART). JAMA, 2007.doi:10.1001/jama.297.3.286
- 2.Atherosclerotic cardiovascular disease in South Asians in the United States: AHA scientific statement. Circulation, 2018.doi:10.1161/CIR.0000000000000580
- 3.Appropriate body-mass index for Asian populations (WHO expert consultation). The Lancet, 2004.doi:10.1016/S0140-6736(03)15268-3
- 4.Erectile dysfunction and cardiovascular disease: systematic review and meta-analysis. European Urology, 2014.doi:10.1016/j.eururo.2013.08.023
Spotted an error or an outdated claim? Report it — we check every report against the research.
Educational information, not medical advice. See a doctor for anything persistent or severe. All content is original to Venva.