The Rising Tide of Cardiac Arrests Among Young Adults in India

A Comprehensive Guide to Heart Health

India is witnessing an unsettling rise in cardiac arrest cases among young adults succumbing to sudden cardiac events. These incidents are stark reminders of the silent yet pervasive threat of heart disease, particularly Atherosclerosis, the leading cause of heart-related deaths globally.

Here’s what every Indian should know about heart health, its risks, and actionable steps to safeguard against it.

But what exactly is Atherosclerosis?

Atherosclerosis is a chronic condition where the arteries, which are the blood vessels responsible for carrying oxygen and nutrients from the heart to the rest of the body, become narrowed and hardened due to the buildup of plaque. This plaque is made up of fat, cholesterol, calcium, and other substances found in the blood.

Myth of Sudden Death:

While seemingly sudden, cardiac arrest is often the culmination of years of underlying atherosclerosis, a condition characterized by the buildup of plaque within the arteries. Contrary to the perception of "sudden death," atherosclerosis is a chronic disease that begins early in life and progresses gradually.

Key Facts About Atherosclerosis:

• India's Leading Killer: Atherosclerosis is the leading cause of death in India and globally.
• Inescapable Reality: Atherosclerosis is an inevitable part of aging. The goal is not to prevent it entirely, but to delay its progression and minimize its impact.
• Early Onset: While often associated with older age, atherosclerosis begins as early as adolescence, with significant consequences observed in young adults.
• Women's Risk: Women are disproportionately affected by atherosclerosis, with a 10-fold higher risk of dying from heart disease than breast cancer.
• Beyond Cholesterol: While cholesterol is often vilified, it is essential for life. The focus should be on the way cholesterol is transported within the body, rather than simply its presence.

How Does Atherosclerosis Develop?

1. Initial Damage to the Endothelium: The inner lining of the arteries, called the endothelium, can become damaged due to factors like high blood pressure, smoking, or high blood sugar.
2. Lipoprotein Entrapment: Low-density lipoproteins (LDL), often referred to as "bad cholesterol," penetrate the damaged endothelial layer and become trapped.
3. Inflammatory Response: The immune system treats this trapped LDL as a threat and sends white blood cells (macrophages) to attack it. These white blood cells consume the LDL, turning into foam cells, which contribute to plaque formation.
4. Plaque Growth: Over time, the plaque grows and hardens, narrowing the artery and reducing blood flow.
5. Complications: The hardened plaque may rupture, causing blood clots to form. If a clot completely blocks blood flow, it can result in a heart attack or stroke.

Risk Factors for Atherosclerosis

Modifiable Risks:

• High cholesterol
• High blood pressure
• Smoking
• Diabetes
• Obesity
• Lack of exercise
• Unhealthy diet

Non-Modifiable Risks:

• Age: Risk increases with age.
• Gender: Men are at higher risk, although women’s risk rises post-menopause.
• Family history of heart disease.

Why Is Atherosclerosis Dangerous?

Atherosclerosis doesn’t produce symptoms in its early stages, making it a silent threat. As arteries narrow or become blocked, it can lead to:

• Coronary artery disease (CAD): Chest pain or heart attack.
• Carotid artery disease: Stroke or transient ischemic attack (TIA).
• Peripheral artery disease (PAD): Pain or numbness in the limbs, gangrene in severe cases.
• Aneurysms: Weakening of the arterial walls, which can rupture and cause life-threatening bleeding.

Can Atherosclerosis Be Prevented or Reversed?

While Atherosclerosis cannot be fully reversed, its progression can be slowed or managed through:

• A healthy diet rich in fruits, vegetables, and whole grains.
• Regular exercise to improve circulation and lower cholesterol.
• Medications like statins to reduce LDL levels.
• Smoking cessation and blood pressure management.
• Regular health screenings to monitor cardiovascular health.

Atherosclerosis is a life-long condition, but with awareness and proactive measures, it can be effectively managed to reduce the risk of severe complications.

Steps to Take Immediately During Heart Attack

1. Call Emergency Services (e.g. 108 in India): Don’t wait; call for medical help immediately. Quick treatment is crucial.
2. Help the Person Sit Down: Keep them calm and seated in a comfortable position, ideally with their back supported and knees bent. This reduces strain on the heart.
3. Loosen Tight Clothing: Make sure they can breathe easily by loosening ties, collars, belts, etc.
4. Monitor Breathing and Pulse: If they become unresponsive and stop breathing, be prepared to perform CPR.