Heart attackMen who smoke and lead an inactive lifestyle have an increased risk of suffering a heart attack, according to a study by doctors in India.

Doctors at the Sir Sunderlal Hospital, Institute of Medical Sciences, Banaras Hindu University, Varanasi, India, looked at 310 patients with acute coronary syndromes (ACS), including heart attack. Of those 310 patients, 51 were aged less than 35 years. Patients were 30 years old on average and 90% were male. The youngest patient was 15 years old.

They found that more than 80% of patients were smokers and 18% were obese. They also found that 59% of patients had low levels of high-density lipoprotein (HDL; also known as the ‘good cholesterol’) and 29% had elevated lipoprotein(a) (LPA), which is known to increase the risk of heart disease and stroke.

The two types of ACS are myocardial infarction and unstable angina. The researchers found that 69% of patients in the study had had a heart attack.

“Heart attack patients were traditionally older than 40 years of age but in the last decade we have seen more and more young adults,” said Dr DP Singh, chief medical officer in the Casualty Department, Sir Sunderlal Hospital.

“Lifestyles of young adults have changed dramatically in recent years which has led to an increase in acute coronary syndromes including heart attacks,” added Dr Singh. “Smoking, physical inactivity and stress are all big problems.

“We found that eight out of 10 young ACS patients smoke. We also showed that nearly one in five are obese and many have unhealthy levels of blood lipids.

“The lifestyles of young adults in India are unrecognisable to those of the previous generation. When I was a student we played sports and cycled but now young people are very sedentary. They are glued to their computers, mobile phones and social media.”

Diets have also changed, with more young adults eating high fat, low fibre diets that include fast food. Coupled with low physical activity it has led to rising levels of obesity and abnormal lipid levels in the blood.

Dr Singh’s previous research has shown that young ACS patients have high stress levels. “Young people are under more pressure today than they were 20 years ago,” he said. “They face a lot of competition for jobs and need to do well in their studies.”

He warned that lifestyle changes were urgently needed to curb the growth of ACS and especially heart attacks in young adults in India. “Young people need to quit smoking, exercise, eat a healthy diet and do yoga to reduce their stress,” said Dr Singh. “Heart attacks are preventable if people look after themselves.”

Professor Santanu Guha, Cardiological Society of India president elect, said: “Heart attacks are increasingly occurring in the younger generation in India because of changes in lifestyle. We have reached a critical point where young adults need to adopt healthier behaviours to avoid a downward spiral towards ill health.”

Professor Roberto Ferrari, a past president of the European Society of Cardiology (ESC) and course director of the ESC programme in India, said: “The rising incidence of heart attacks in young adults in India is worrying. But heart disease can often be prevented. Quitting smoking should be the first priority, followed by being physically active and eating a healthy diet.”

The findings were presented at the 67th Annual Conference of the Cardiological Society of India.