Stress, Sleep Might Be Playing A Greater Role In Weaving Web Of Risk Factors For Heart Disease: Experts

India faces an unprecedented challenge as the cardiovascular disease (CVD) burden is growing faster than ever before, reports highlight that from consultations to procedures - the footfall of patients with heart problems has risen at a fast speed in the last few years. A recent survey done by Reliance General Insurance showed that coronary angiography procedures in the age band of 19-35 increased by 160.87 per cent from 2018-2019 to 2022-2023. Similarly, the total number of CAG procedures in the age band of 36-45 increased by 102.99 per cent from 2018-2019 to 2022-2023. 

Globally as well India faces a bigger brunt as Indians have relatively a higher risk burden with an early age onset, higher mortality rate and higher premature deaths. According to the World Health Organization (WHO) CVDs account for 45 per cent of deaths in the 40-69 year age group in India. 

“It's disheartening to witness the escalating number of heart disease patients. What's even more distressing is the decreasing age of onset. Younger individuals are increasingly grappling with heart issues,” states Dr Sathyaki P Nambala, Chief Surgeon, Department of Robotic & Minimally Invasive Cardiac Surgery, Apollo Hospitals, Bannerghatta Road, Bangalore.

Clinicians believe that there are multiple factors responsible for this concerning trend including sedentary lifestyle, smoking, obesity, uncontrolled cholesterol and predisposition to diabetes and hypertension. However clinical experts today are also signaling towards a bigger culprit which is stress that might be orchestrating several of these changes in the human body. 

Dr Jyoti Kapoor, Founder-Director and Senior Psychiatrist, Manasthali says that stress is the silent architect of heart disease, weaving a web of risk factors that can shatter the strongest of hearts. Dr Kapoor says that it's not just an emotional burden but it's a potent risk factor for heart disease. 

“When stress takes centre stage in our daily existence, it orchestrates a symphony of physiological changes that can, over time, harm our cardiovascular health. Like a relentless storm, chronic stress can erode the resilience of our hearts, leading to increased blood pressure, inflammation, and unhealthy lifestyle choices,” Dr Kapoor states.

She further explains that it's as if stress writes a tragic script, where the heart plays the unwitting protagonist, bearing the burden of a narrative laden with risk adding that to protect the heart's sanctity, we must become vigilant guardians of our well-being, mastering the art of stress management. “As we unravel the knots of tension, we fortify the heart's defences, nurturing a future where stress is but a fleeting gust in the gentle breeze of a healthy heart,” Dr Kapoor adds.

Dr Sibasish Dey, Head, Medical Affairs, South Asia, ResMed says that the importance of sleep cannot be stressed enough to maintain a healthy heart adding that several important functions like repair of tissues, primary homeostatic functions, restoration of energy, immune regulation and so on take place during sleep. 

Dr Dey says that apart from providing the needed rest to the cardiovascular system, adequate quality and quantity of sleep reduces oxidative stress and hence also reduces the risk associated with the development of atherosclerotic plaques. 

India is the second most sleep-deprived nation, with an average bedtime of seven hours and one minute as per a study by a US-based firm, Fitbit. Japan led the charts and was the most sleep-deprived among the 18 countries surveyed which were surveyed. 

Research published in the medical journal PubMed says that the majority of the Indian population has some type of sleep disorder with symptoms of insomnia in over 78 per cent of the population and 29 per cent of people having moderate to severe insomnia. 

“Very often, quality of sleep is compromised which may lead to cardiac disorders and may also increase the risk of a heart attack in the long run. There could be several reasons for disturbed sleep and sleep disorders like Obstructive Sleep Apnea (OSA) is one of them. As per clinical studies, OSA is associated with stroke in 72 per cent of cases, 76 per cent chances of heart failure and 83 per cent of cases of drug-resistant hypertension,” Dr Dey explains. 

He adds that in such cases, sleep therapy must be sought along with some behavioural changes adding that to ensure robust heart health, one can take key measures as defined by the American Heart Association’s (AHA) “Life’s Essential 8” which are to eat better, be more active, quit tobacco, get healthy sleep, manage weight, control cholesterol, manage blood sugar, and blood pressure.

Describing the symptoms of a heart attack Dr Chirag D, Consultant Interventional Cardiologist, SPARSH states that both genders share certain common symptoms irrespective of gender, and variations can emerge in how these symptoms manifest between men and women. Dr Chirag says that women, for instance, might experience less specific warning signs such as nausea and unexplained fatigue or light-headedness while men often present with more classical symptoms like chest pain, or discomfort radiating down the left arm.

“Nevertheless, it's essential to acknowledge that symptoms can vary significantly among individuals, and some may not display any discernible warning signs before experiencing a heart attack. Consequently, it remains critical for both men and women to familiarize themselves with the symptoms of heart attack and promptly seek medical attention if they encounter any unusual or severe symptoms,” Dr Chirag delineates. 

On this World Heart Day, Dr Nambala advises embracing an active lifestyle, arguably the most vital step in heart protection. He also says that one should consume food mindfully, avoid known heart disease culprits such as high cholesterol and fried foods, avoid smoking and resisting excesses in all aspects of life.