We know, heart attacks are on the rise… But do we know the majority of them are preventable? Cardiovascular disease now claims over 20 million lives a year, and roughly 80% of those deaths are due to risk factors that can be prevented or managed.

This is the uncomfortable reality which requires action. On September 29, the World Heart Federation celebrates World Heart Day under the theme "Don't Miss a Beat", a campaign built on three objectives: see the signs, protect your heart, accessible treatment.

Despite major advances in diagnosis and treatment, the total number of people developing and dying from heart problems and stroke continues to rise due to population growth, aging, and increasing risk factors.

What are those risk factors?

Nine risk factors, ninety percent of the risk

In the interesting INTERHEART study, which examined heart attack patients across 52 countries, found that nine modifiable risk factors account for more than 90% of first heart attacks: high blood pressure, abnormal cholesterol, smoking, diabetes, abdominal obesity, psychosocial stress, physical inactivity, low intake of fruit and vegetables, and heavy alcohol use.

Hypertension is the most dangerous risk factor because there are no symptoms generally and hypertension is not considered as disease by many. A person with fever reaches a hospital within two days. Someone with a blood pressure of 170/100 may walk around for a decade without knowing, because it is silent; hence the name “silent killer” there is nothing.

• Nearly 50 % of adults with hypertension are unaware of their condition.
• Only 40% are diagnosed and treated. Among them, only one fifth achieve good blood pressure control.

Hypertension contributes to over 10 million deaths a year, making it one of the single largest preventable causes of death in the world. A blood pressure check once a year from the age of 40 is the cheapest insurance in medicine.

Abnormal cholesterol levels in blood – increased levels of low-density lipoprotein cholesterol (LDL – bad cholesterol), and lower levels of high-density lipoprotein cholesterol (HDL- good cholesterol) are the important risk factors. Early detection through lipid screening and aggressive treatment of elevated LDL cholesterol can significantly reduce the risk of heart attack, stroke, and cardiovascular death, making lipid optimization a cornerstone of modern cardiovascular prevention.

Smoking - Smoking and secondhand smoke attribute to 20% of these cardiovascular deaths at a much younger age. Tobacco cessation remains one of the most effective steps a person can take for heart health.

Diabetes - In India, diabetes often appears earlier and is associated with multiple other cardiovascular risk factors, creating a higher lifetime risk. Indians with diabetes develop coronary artery disease 10 years earlier than many Western populations. Strict control of sugar levels should be achieved with appropriate medicines, healthier food choices which should include salads, fruits and wholesome grains and millets and regular exercise.

Physical inactivity, unhealthy diets and stress are equally important. Experts recommend at least 150 minutes of moderate aerobic activity each week, such as brisk walking, along with strength training twice a week. A diet rich in fruits, vegetables, whole grains and healthy fats, while limiting salt, trans fats and highly processed foods, supports long-term cardiovascular health. Heavy alcohol intake, poor sleep and unmanaged stress can further increase risk.

Glycemic control + BP control + LDL reduction + smoking cessation + weight management + physical activity + Good diet + Stress management = Low risk of heart attack

Scandinavian countries offer valuable lessons. Sweden, Norway, Denmark and Finland have achieved sustained declines in cardiovascular mortality through prevention (e.g., higher use of statins, lower smoking rates), strong public-health systems and rapid treatment.

In India, this can be achieved by

Creating awareness on risk factors, symptoms, good diet and exercise,

Regular checkups for blood pressure, sugar and cholesterol,

Appropriate treatment of risk factors,

Strengthen STEMI networks,

Legislate on salt, trans fats, tobacco and air pollution.

And individually, start now: a diet rich in fruits, vegetables, whole grains, millets and healthy fats, under 5g of salt a day, 150 minutes of exercise a week with strength training twice, no tobacco, good sleep — and, above all, know your numbers.

Don't miss a beat.