Dr. Syed Akram Ali, a cardiologist based in Hyderabad, recently highlighted a concerning case involving a 37-year-old man who, despite maintaining a healthy lifestyle that included running 5 kilometers daily, avoiding junk food, having no vices, and adhering to a regular sleep schedule, required two stents in his heart. In an Instagram post, Dr. Ali described how this individual, who appeared fit and healthy, experienced chest pressure and heaviness in his left arm, leading him to undergo angiography, which revealed two significant blockages requiring stent placement.
Dr. Ali emphasized that hidden factors often overlooked can drastically impact heart health, particularly genetic predispositions. He explained that individuals with a family history of early heart disease face a 2 to 3 times higher risk, regardless of their fitness level. He also pointed out lipoprotein(a), a type of cholesterol not routinely tested, as a significant contributor to heart issues. According to Dr. Ali, even with normal lipid profiles, high levels of lipoprotein(a) can lead to arterial blockages.
Another contributing factor to heart problems is the high stress associated with corporate lifestyles. Dr. Ali noted that while running 5 kilometers daily is beneficial, it does not equate to effective stress management. Elevated stress levels can lead to increased adrenaline, blood pressure, inflammation, and the formation of microplaques in the arteries.
Chronic inflammation, as indicated by C-reactive protein (CRP) levels, is another hidden risk factor. Dr. Ali explained that many seemingly fit individuals may have underlying inflammation that accelerates artery damage, which is not typically assessed in standard medical check-ups. Additionally, poor sleep habits, such as inadequate sleep and prolonged screen time, can lead to metabolic strain, raising cortisol levels and contributing to blood thickening and plaque instability.
Misconceptions about fitness also play a role in heart health. Dr. Ali asserted that while running may enhance fitness, it does not ensure clean arteries. He emphasized that heart disease results from a combination of genetics, lifestyle, inflammation, stress, sleep quality, and lipoprotein levels.
To further investigate these issues, Dr. Parin Sangoi, an interventional cardiologist at Wockhardt Hospitals in Mumbai, reiterated that physical fitness alone does not guarantee healthy arteries. He highlighted that individuals may have good endurance but still develop plaque in their coronary arteries due to genetic factors, including family history or elevated lipoprotein(a) levels, which can accelerate plaque formation even when conventional cholesterol metrics appear normal.
Dr. Sangoi pointed out that lipoprotein(a) is a genetically determined cholesterol particle that does not show up in standard lipid tests. Elevated levels significantly heighten the risk of early heart attacks and severe arterial blockages, often without warning signs, even in young, fit individuals.
Dr. Rahul Gupta, director and cardiologist at Gleneagles Hospital in Parel, added that chronic stress, especially prevalent in corporate settings, exacerbates blood pressure, inflammation, and plaque formation—effects that exercise alone cannot counteract. He noted that poor sleep quality, excessive screen time, and unaddressed inflammation can further compromise arterial health. Many seemingly fit individuals may also have high CRP levels, insulin resistance, or elevated homocysteine—conditions that are not detected in basic health screenings. Therefore, a normal lipid profile or routine running regimen may not suffice for maintaining heart health.
Dr. Sangoi suggested that markers such as HS-CRP for inflammation, ApoB, HbA1c, fasting insulin, and homocysteine could provide a more detailed assessment of cardiovascular risk. In some cases, a coronary calcium score can reveal early plaque formation before symptoms manifest. Both Dr. Gupta and Dr. Sangoi emphasized the importance of advanced testing and preventive evaluations to truly safeguard heart health, stressing that heart disease results from a complex interplay of genetics, inflammation, stress, sleep, and metabolic conditions.
DISCLAIMER: This article is based on information from public sources and interviews with experts. It is advisable to consult a healthcare professional before initiating any health regimen.
