A growing body of medical opinion is shifting the focus of heart care from emergency treatment to early prevention. Dr Sanjay Bhojraj, a longevity medicine physician and board-certified interventional cardiologist, underscores this shift in his recent Instagram post, urging people to rethink when they should start paying attention to their heart health, ideally well before age 50.
Reflecting on his practice, he notes, “For 20 years, I was the cardiologist people came to after the system had already failed them,” highlighting a reactive healthcare model where intervention often begins too late. He adds, “After the blockage was there, the stent was needed, and the emergency was real. But the question that changed my career was: Why did we wait until the artery was already diseased to start calling this heart care?”
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.
According to him, the condition of your heart by midlife is not accidental but cumulative. “By 50, your heart is often reflecting the last 20 years of your metabolism, stress biology, sleep, blood sugar, inflammation, muscle mass, hormones, gut, and daily repair capacity,” he explains.
He also challenges a common misconception that the absence of symptoms equals good health. “The worst part? Most people are still being told they’re ‘fine’ because they don’t have any blatant alarm bells showing up yet. That is not prevention,” he says.
Instead, he advocates for deeper, earlier assessment:
“Prevention is knowing whether your body is building plaque before you feel symptoms.”
“It’s understanding whether your blood sugar is damaging your vessels, even if you’re not diabetic.”
“It’s asking why your blood pressure is rising instead of only asking how to suppress it.”
While he acknowledges the importance of medical advancements, he emphasises a more proactive approach: “I still believe in modern cardiology. But I also know this: The best heart procedure is the one you never need.” He concludes with a call for earlier awareness, stating, “That is the conversation I wish more people were having before 50.”
Early, often overlooked signs or internal markers individuals should monitor to assess their heart health
Dr Bilal Ahmed Baba, Senior Consultant – Cardiology, Marengo Asia Hospitals, Gurugram, tells indianexpress.com, “Many cardiovascular problems develop silently for years before symptoms appear. Feeling “normal” does not always mean the heart and blood vessels are healthy. In many cases, risk factors show up long before chest pain, heart failure, or stroke develops.”
Story continues below this ad
Some of the most important early markers, according to Dr Bilal include:
Vital signs
- Blood pressure: Persistent readings above 130/80 mmHg deserve attention, as hypertension is one of the strongest predictors of heart attack, stroke, kidney disease, and heart failure.
- Resting heart rate: A persistently elevated resting pulse may suggest deconditioning, cardiovascular stress, thyroid problems, anaemia, arrhythmias, or autonomic dysfunction.
- Waist circumference and body composition: Central abdominal obesity is strongly linked to insulin resistance and coronary artery disease, even in people who are not significantly overweight.
Physical signs people often ignore
Several subtle changes can precede major cardiovascular disease:
- Reduced exercise tolerance
- Breathlessness while climbing stairs
- Unusual fatigue
- Poor recovery after exertion
- Mild ankle swelling
- Palpitations or skipped beats
- Dizziness or near-fainting episodes
- Erectile dysfunction in men, which can precede coronary artery disease by years
- Loud snoring and daytime sleepiness are suggestive of sleep apnea
“One of the earliest clues to declining cardiovascular health is often not dramatic symptoms, but a gradual decline in stamina — ‘I can still do things, but not as easily as before,’” says Dr Bilal.
How individuals in their 30s and 40s can track and improve metabolism, stress, sleep, and inflammation
Heart disease prevention is usually far more effective than treating advanced disease later. Dr Bilal states the most powerful protective measures are often simple habits practised consistently over many years.
Exercise regularly
Aim for:
Story continues below this ad
- At least 150 minutes per week of moderate aerobic activity such as brisk walking, cycling, or swimming
- Strength training 2–3 times per week
Even daily walking has significant cardiovascular benefits.
Track metabolic health
People in their 30s and 40s should periodically monitor:
- Blood pressure
- Fasting glucose and HbA1c
- Cholesterol levels
- Waist circumference
- Weight trends
Central abdominal fat and worsening metabolic markers often develop gradually and silently over time.
Prioritise sleep
Poor sleep is strongly associated with:
- Hypertension
- Obesity
- Insulin resistance
- Arrhythmias
- Increased cardiovascular risk
Adults should aim for consistent, good-quality sleep and seek evaluation for symptoms such as loud snoring, excessive daytime sleepiness, or poor sleep quality that may suggest sleep apnea.
Story continues below this ad
Manage stress effectively
Chronic stress can contribute to elevated blood pressure, inflammation, poor sleep, unhealthy eating habits, and reduced physical activity.
Helpful strategies include:
- Regular exercise
- Mindfulness or meditation
- Maintaining healthy social relationships
- Reducing excessive work stress where possible
- Seeking support for anxiety or burnout when needed
Follow a heart-friendly diet
Cardioprotective diets generally emphasise:
- Vegetables and fruits
- Whole grains
- Nuts and legumes
- Fish and unsaturated fats
- Minimally processed foods
Reduce sedentary time
Dr Bilal mentions that even individuals who exercise regularly can be negatively affected by prolonged sitting. Frequent movement throughout the day matters.
“Avoiding smoking and limiting heavy alcohol intake are also among the most important long-term cardiovascular protective measures,” concludes the expert.
Story continues below this ad
DISCLAIMER: This article is based on information from the public domain and/or the experts we spoke to. Always consult your health practitioner before starting any routine.