Heart Health After 40: What to Know

Heart disease is India's #1 killer — and Indians develop it roughly 10 years earlier than Western populations. After 40, prevention becomes urgent, not optional.

Why Indians are higher risk. South Asians have genetic predisposition to smaller coronary arteries, higher levels of Lipoprotein(a), lower HDL, and abdominal fat deposition. Even thin Indians can have "TOFI" — thin outside, fat inside.

Screenings you need annually after 40: Complete lipid profile, fasting blood sugar + HbA1c, blood pressure, ECG, and ideally a Lipoprotein(a) test once in your life. Consider a coronary calcium scan at 45–50 if you have family history.

Know your numbers. Target LDL under 100 (under 70 if high-risk). BP under 130/80. Fasting sugar under 100. Waist circumference under 90 cm (men) or 80 cm (women). Triglycerides under 150.

The 30-minute rule. 30 minutes of moderate exercise (brisk walking, cycling, swimming) 5 days a week reduces heart attack risk by 35%. Add 2 strength sessions weekly — muscle mass protects metabolic health.

Warning signs NOT to ignore. Chest tightness on exertion that improves with rest, unusual shortness of breath climbing stairs, jaw/arm pain, sudden cold sweats, or new-onset fatigue. Women often present with nausea or back pain — not classic chest pain.

The 4 lifestyle non-negotiables: Don't smoke. Keep BP and sugar controlled. Sleep 7+ hours. Manage stress actively. These 4 alone cut cardiac risk by over 70%.

Consider aspirin carefully. Low-dose aspirin was once routinely prescribed for prevention. Current guidelines are more selective — discuss with your doctor based on your individual risk profile, as bleeding risks can outweigh benefits for low-risk patients.