SUDDEN CARDIAC DEATHS AMONG YOUNG INDIANS
Sir Ganga Ram Hospital
By definition Premature Coronary Artery Disease occurs at a young age, less than 55 years in men & 65 years in women. Many studies have found that Indians are prone to CAD at younger age, this should worry us.
Why Are Young Indians More Vulnerable To Sudden Cardiac Arrest? To stay on top of your health, one must start following healthier lifestyle practices on a day-today basis. One should also be aware of their family history if any and take the necessary precautionary measures. Sudden cardiac arrest occurs without a warning, bringing the heart to a standstill. It is not surprising to see the rising incidence of heart diseases among the youth in today's age. According to recent American research, it has been observed that there is a 13% increase in sudden cardiac arrest among those aged mid30s to mid-40s. Further, as per the Indian Heart Association, when heart disease strikes Indians, it tends to do so at an earlier age than other demographics, often without warning. Few studies have found that Indians suffer from heart diseases at least 10 years before people in the West. Incidence of Sudden Cardiac Arrest (SCA) among youngsters are rising due to sedentary lifestyles, diabetes, increasing consumption of alcohol, smoking, stress and hypertension. Some patients, however, may not have any known risk factor. Therefore, there is a need to create awareness around SCA among the youth by encouraging them to get regular checkups.
We have lost many young Indians due to sudden cardiac deaths. A power star
Puneet Rajkumar, actor in Kannad cinema, collapsed after a morning workout and died within an hour. These untimely deaths make us rethink coronary artery disease of young. India is a young country. We do have a higher number of unexpected and untimely deaths. Documenting the changing landscape of CVDS over the past two decades, they have come up with similar conclusions — heart diseases cause the maximum deaths in India and the number is on a steady rise.
Since CVD strikes Indians nearly a decade earlier than other populations, a large number of heart attacks happen to people between 30 and 69 years old.
“Nearly 30 per cent of heart attacks come suddenly, and unexpected in otherwise healthy and healthy looking individuals. Experts list the rapid expansion of the disease in the population, early age of disease onset and high case fatality rate as a particular cause of concern in the Indian CVD epidemic.
India’s epidemiological transition from infectious to non-communicable diseases took place rather fast. Between 1990 and 2010, premature mortality in terms of years of life lost rose by 59 per cent, from 2.32 crore to 3.7 crore. Despite wide variations in the prevalence of risk factors, CVD has emerged as the leading cause of death in all parts of India, including poorer states and rural areas, mainly due to lifestyle changes.
"Between 1990 and 2015, the prevalence of the CVD rose by more than 50 per cent in India and in a population of more than a billion people, 10 per cent people without any risk factors, may suddenly experience a heart attack,”
There are several such incidents in recent memory. A month before Puneeth Rajkumar’s tragic death, Siddharth Shukla, a 40-year-old television actor and one of the winners of the Bigg Boss reality show died suddenly, following a complaint of chest pain at night.
In June, film director and producer Raj Kaushal, 49, died of a heart attack.
Even sportspersons, whose physical fitness is a professional requirement, have not escaped the disease. A couple of years back, in 2019, Radhakrishnan Dhanarajan, a former East Bengal and Mohan Bagan defender collapsed during a match in Kerala and could not be revived. He was 39 years old.
Sports lovers in Bengaluru may also recall the tragic death of Cristiano Junior. The 25-year-old Brazilian footballer collapsed at the Sree Kanteerava Stadium while playing in a Federation Cup match and died.
Why more Deaths ?
Between 2000 and 2015, India’s mortality due to heart attacks among males rose from 48 per 100,000 to 61 per 100,000 for people between 35 to 39 years of age. The increase was equally stark in the 40 to 44 years category (from 85 per 100K to 106 per 100K); 45 to 49 years (from 134 to 170); 50 to 54 years (from 226 to 282) and 55-59 years (from 357 to 408).
Over the years, medical researchers have gathered enough evidence to show that death due to cardiovascular disease is on the rise in India. CVDS caused more than a quarter of all deaths in the country in 2015 and are now affecting rural populations and young adults the most.
The first nationally representative study to track cardiovascular mortality in India over 15 years showed that the chances of dying from ischaemic heart disease (IHD) — cardiac issues caused by a narrowing of the heart’s arteries — in populations aged 30 to 69 have increased.
Between 2000 and 2015, the mortality rate rose from 10.4 per cent to 13.1 per cent in men and 4.8 per cent to 6.6 per cent in women.
A study from Toronto, Canada found that heart attack mortality rates rose rapidly in rural India and surpassed those in urban areas between 2000 and 2015.
"Myocardial Infarctions among Indians less than 45 years old is a huge problem. Two recent studies from Tamil Nadu and Gujarat show that 24 - 26 per cent of such cases occur in young Indians. The corresponding number in the western population is 5 to 7 per cent,” said Thomas Alexander, an interventional cardiologist from Kovai Medical Centre and Hospital at Coimbatore.
While mortality due to heart attacks is increasing in the age 30 to 45 year age group, the largest increase was actually seen among women around the age of 35 years.
“The maximum increase for ischaemic heart disease mortality for men was 2.4 per cent annually in those aged 50–54 years and for women was 2.8 per cent in those aged 35 to 39 years”
Why Does It Happen?
Sudden cardiac arrest occurs without a warning, bringing the heart to a standstill. It occurs because of erratic heartbeats triggered by an electrical malfunction that stops the heart from pumping blood to the body. Sudden Cardiac Arrest leads to sudden death of a person if not intervened within the first 6 minutes. The human heart beats around 60-100 beats per minute and any fluctuation in this rate, either too slow (Bradycardia) or too fast (Tachycardia) is referred to as cardiac arrhythmia. Those experiencing a sudden increase in heart rate or those who are genetically prone to heart diseases can experience a fatal arrhythmia.
The management of SCA involves the crucial step of performing a Cardiopulmonary Resuscitation (CPR) within the first 6 minutes. This can greatly improve the chances of survival as it immediately restarts heart functions and provides blood supply to the brain.
Reasons
Neglected and unsupervised high blood pressure is associated with about 6 to 8 times the odds of dying from ischemic heart disease. But it is an even stronger risk factor for heart attack mortality among younger adults. In the age group of 30 to 39 years, elevated blood pressure increases the odds of dying from a heart attack by 12 times. An electronic medical record based study in India is over 58,701 patients showed that over 50% of patients with Heart disease in India were in the 40-64 year age group. The gap is narrowing.
Most common complaints
• Chest Pain (76%)
• Dizziness (10.4%)
• Fever (8.15%)
• Nausea (5.4%) Common Comorbidities Present
• Hypertension (48%)
• Diabetes Mellitus (45%)
• Dyslipidemia (5.6%)
Studies have also shown that high blood pressure is driving the increase in IHD deaths, especially in rural areas; as such risk factors are no longer restricted to urbanised populations. “Also among younger males, smoking plays an important role.”