Fit Outside, Fragile Within: Rising Heart Deaths in Youth

Heavy gym workouts may raise heart death risk in people with genetic vulnerabilities, highlighting the need for caution and screening.

A surge in heart-related deaths among young adults in India is alarming doctors, with experts pointing to a dangerous mix of genetic predisposition and unhealthy lifestyle habits such as binge drinking, poor sleep, and chronic stress.

Recent cases have raised concern because many of the victims were seemingly fit and appeared to lead healthy lives. Experts warn that hidden genetic factors, combined with modern lifestyle risks, are contributing to a silent but deadly epidemic.

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TOP INSIGHT

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Genetic Factors Raise Risk of Early Heart Attacks

“About 20 percent of heart-related deaths in India are caused by genetic factors,” said Dr. Rajiv Bhal, Director General of the Indian Council of Medical Research (ICMR). He highlighted two major inherited risks: familial hypercholesterolemia (FH) and elevated lipoprotein(a), both strongly linked to early and severe heart disease.

Globally, FH affects around 1 in 250 people, () but in India, it is implicated in 15 percent of heart attacks occurring below the age of 40. Elevated lipoprotein(a), meanwhile, is found in about 25 percent of Indians, and levels above 50 mg/dL are common among young heart attack patients, directly correlating with the severity of coronary artery disease.

“Genetic testing is the gold standard for diagnosing FH, but since it is not widely available, we use the Dutch Lipid Clinical Network (DLCN) criteria,” explained Dr. J.P.S. Sawhney, Chairperson of Cardiology at a leading Delhi hospital.

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He stressed the importance of cascade screening—testing siblings and children of diagnosed patients through fasting lipid profiles. “If cholesterol levels are high, we start treatment as early as two years of age. This early intervention can prevent premature heart attacks,” Sawhney noted.

Currently, there is no specific treatment for elevated lipoprotein(a). However, ongoing global trials on targeted therapies may bring new options by 2026. Until then, doctors recommend strict control of other risk factors such as diabetes, hypertension, and high cholesterol.

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Lifestyle Choices Add Fuel to the Fire

Beyond genetics, lifestyle factors are accelerating the crisis. Dr. Bhal cited binge drinking, silent hypertension, growing stress levels, sleep deprivation, and childhood obesity as major contributors.

He also warned against overexertion in gyms, particularly for individuals with genetic risks. “Heavy exercise without proper medical evaluation can put people with faulty genes at even greater risk of sudden heart-related deaths,” he said.

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To counter this trend, Bhal emphasized six key habits for better heart health: regular physical activity, no smoking, adequate sleep, a healthy diet, stress reduction, and meditation.

India is witnessing a worrying rise in sudden cardiac deaths among young adults, often striking those in their 20s and 30s. While lifestyle changes are urgently needed, experts stress that genetic awareness and early screening could play a decisive role in prevention.

As Dr. Sawhney summed up, “Identifying and managing genetic risks early, alongside tackling lifestyle factors, is crucial if we want to stop this surge in premature heart-related deaths.”

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