Heart attack clues start about 10 years earlier, warns CMC Vellore-trained doctor. And most people miss them
— hyderabaddoctor (@hyderabaddoctor)
Importance of Sustained Physical Activity
Heart attacks often catch people by surprise, but emerging evidence shows that warning signs can start nearly ten years before the event. Many individuals miss these early indicators because they are subtle and develop gradually over time. Declining physical activity, in particular, has been identified as a key early clue that signals the risk of future cardiovascular problems.This finding comes from experts, including Dr. Sudhir Kumar, a neurologist trained at CMC Vellore and currently practising at Apollo Hospitals in Hyderabad.Dr. Kumar points out in an X post that moderate-to-vigorous physical activity (MVPA)—activities like brisk walking, cycling, or swimming—begins to fall around 12 years before cardiovascular disease is diagnosed. While some reduction in physical activity is normal with age, the decline is much sharper and more significant in those who later develop heart disease, especially in the two years before diagnosis.This pattern suggests that a steady drop in physical activity is more than a natural part of aging; it can be an early sign of underlying heart problems.The Coronary Artery Risk Development in Young Adults (CARDIA) study, published in JAMA Cardiology, echoes these findings. Researchers followed participants from young adulthood to midlife and observed that those who eventually suffered cardiovascular events showed a marked and steady decline in physical activity starting about 12 years before the event, with a faster drop in the last two years.The study also revealed that Black women had the lowest activity levels throughout adulthood and faced greater risks after cardiovascular incidents.Experts emphasize maintaining regular moderate-to-vigorous physical activity for at least 150 minutes weekly throughout life. Dr. Kumar advises that waiting for a heart event before becoming active is too late. Instead, building and sustaining healthy activity habits early on is crucial to reducing risk. After any heart-related episode, gradual resumption of physical activity with medical guidance supports recovery and long-term heart health.Consistent physical activity remains the most effective way to prevent heart disease and improve outcomes after a cardiac event. Recognizing early clues like declining activity can prompt timely medical attention. Staying active throughout adulthood is essential for protecting heart health over a lifetime.
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New Indian Express
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- New Indian Express
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Time of India
9 hours ago
- Time of India
Your heart sends warnings 12 years before a heart attack; here's the sign most people miss and preventions steps you need to know now
Heart attacks are usually framed as sudden emergencies, but research shows they commonly follow a slow, silent buildup that begins long before pain or hospital alarms. A major analysis of CARDIA participants found that moderate-to-vigorous physical activity (MVPA) — things like brisk walking, cycling or swimming — often starts a steady decline about 12 years before a cardiovascular diagnosis, with the pace accelerating in the final two years. Experts including Dr. Sudhir Kumar (Apollo Hospitals, Hyderabad) warn that this gradual loss of stamina is frequently misread as normal ageing; spotting it early creates a large window for prevention, screening and targeted lifestyle or medical interventions that can avert major cardiac events. Physical activity often starts falling 12 years before heart disease: Study The paper titled 'Trajectories of Physical Activity Before and After Cardiovascular Disease Events in CARDIA Participants' analysed physical activity data collected across decades from participants first enrolled in 1985–86. Researchers used repeated activity assessments (multiple timepoints through midlife) to model long-term trajectories and compare people who later developed cardiovascular disease (CVD) with those who did not. The key quantitative findings: MVPA began to decline, on average, roughly 12 years before a first CVD event; declines steeped in the two years immediately before diagnosis; and low activity levels tended to persist after the event, widening the gap versus peers who remained CVD-free. by Taboola by Taboola Sponsored Links Sponsored Links Promoted Links Promoted Links You May Like No annual fees for life UnionBank Credit Card Apply Now Undo The study used CARDIA's longitudinal design to reveal this long preclinical window rather than a single cross-sectional snapshot. CARDIA tracked moderate-to-vigorous physical activity (MVPA) — activities that raise heart rate and breathing noticeably (brisk walking, jogging, cycling, swimming, sports). In practice, MVPA estimates came from validated activity questionnaires administered repeatedly; these give a life-course view rather than a one-off reading. Because changes emerged gradually over a decade, the timing matters: a single clinic visit that notes 'low activity today' can miss whether someone is on a downward trajectory. Longitudinal decline, especially an accelerating fall in MVPA is the important signal researchers flagged. Changes that raise heart disease risk A sustained drop in MVPA is not just a lifestyle statistic; it maps to several physiologic changes that raise cardiovascular risk: Cardiac deconditioning: Less habitual activity reduces cardiac stroke volume and aerobic capacity, so daily exertion becomes harder. Endothelial and vascular changes: Lack of movement promotes poorer endothelial function and favours atherogenic plaque formation. Metabolic effects: Inactivity increases the risk of weight gain, insulin resistance and adverse lipid changes — all major drivers of atherosclerosis. Inflammation and autonomic imbalance: Sedentary behaviour links to low-grade inflammation and less favourable autonomic (heart rate variability) profiles. Together, these pathways mean a progressive drop in MVPA both reflects and contributes to the biological processes that eventually cause heart attacks or strokes. For public guidance, major health bodies emphasise staying active because of these mechanistic links. MVPA declines over time reflect race and gender inequalities in heart health CARDIA authors also examined demographic patterns. While MVPA tended to decline across all groups with age, the trajectory and baseline levels differed by sex and race. Notably, the study found that Black women recorded consistently lower activity levels across adulthood, and certain groups showed more continuous declines — patterns that can concentrate cardiovascular risk in already disadvantaged populations. These findings imply prevention must be tailored: population-level recommendations are necessary but insufficient without culturally and structurally appropriate supports. Think longitudinally, not just cross-sectionally. A single 'low activity' datapoint is less informative than a trend; clinicians should ask about changes in routine and stamina over years. Use risk tools alongside functional history. Tools such as the ASCVD Risk Estimator help assess 10-year risk, but trend information about MVPA can flag patients who might benefit from earlier screening or intervention. Act early. Declining MVPA constitutes a window for action — lifestyle counselling, targeted exercise support, and if indicated, medical risk-factor treatment (BP, lipids, glycemia). The earlier the intervention, the greater the chance of preventing an event. How to evaluate a patient's steady decline in stamina If a patient reports a steady, unexplained fall in activity or stamina, reasonable initial steps include: Basic cardiovascular screening: blood pressure, BMI/waist measure, lipid panel, fasting glucose/HbA1c. Calculate ASCVD or other validated risk scores (for patients in the appropriate age range) to guide intensity of preventive therapy. Functional assessment: a simple timed walk or effort-tolerance discussion can be very revealing; refer for formal stress testing only if clinical suspicion of ischemia is present. Consider social drivers: ask about work, caregiving, safety, access to safe walking spaces and time pressures — these often explain activity declines and must be addressed. From prevention to recovery: Practical guidelines for safe and sustainable cardiovascular fitness Public health and cardiology bodies recommend at least 150 minutes per week of moderate-intensity activity (or 75 minutes of vigorous activity) as a baseline goal for adults; more gives additional benefit. Practical tips to meet and sustain MVPA: Break activity into short, consistent bouts (eg. , 30 minutes, 5 days/week). Choose enjoyable activities (walking, cycling, swimming, dance) to improve adherence. Build movement into routines (active commuting, stairs, standing breaks at work). Set trajectory goals rather than single-day targets (track weekly MVPA minutes). Address barriers (childcare, unsafe neighbourhoods, pain) with tailored solutions or supervised programs. If someone does have a cardiovascular event, the evidence strongly supports early referral to structured cardiac rehabilitation (CR). CR combines monitored exercise, risk-factor management, nutrition and psychosocial support; it reduces mortality and improves functional recovery. Typical guidance: begin activity gently (short walks) in hospital recovery, progress under supervision to 30+ minutes of aerobic activity several times weekly, and incorporate supervised outpatient CR when available. How to track activity trends (tools that help detect a worrying decline) Wearables and phone apps: track MVPA minutes and weekly totals. Look for a sustained downward slope over months/years, not day-to-day noise. Simple logs: a weekly activity diary or 6-minute walk distance recorded every few months provides a low-tech trend. Clinical prompts: clinicians should routinely ask, 'Compared with two years ago, do you find doing your usual activities harder?' A 'yes' can prompt further evaluation. 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Time of India
16 hours ago
- Time of India
Study finds heart trouble can start a decade before cholesterol or blood pressure raise alarms
Imagine you're cruising through your 20s and 30s, enjoying life, maybe hitting the gym or walking the dog. Then, without a dramatic event, your energy starts to dip. You move less, sleep more, skip workouts more often—not because you're lazy, but because life gets busy, health shifts, or routines change. This downward trend isn't just a sign of ageing—it might be an early whisper from your heart. A recent study in JAMA Cardiology has surfaced this subtle red flag: people who later developed heart-related conditions, like heart attacks, strokes, or heart failure, actually showed a dip in their moderate-to-vigorous physical activity (MVPA) around 12 years before their diagnosis. That's more than a decade of downshifting before things got serious. Here's what they found: across more than 3,000 adults tracked from their mid-20s into late middle-age, physical activity naturally tapered off over time. That's kinda expected but those who eventually ended up with cardiovascular disease (CVD) experienced a sharper, earlier drop in activity, especially about two years before the actual diagnosis. Let's pause on that: this decline started way before any red flags in your cholesterol or blood pressure, before you knew something was off. It's like the heart sending a whisper, not a shout. And that gives us a huge window to act, to course-correct—and maybe even stop things from getting worse. But there's more to the story. The study also unpacked how this trend varies across different groups. That's a big red flag pointing at inequities in opportunity, support, access, things like safe places to exercise, affordable options, flexible schedules—all the real-world stuff that shouldn't be overlooked. Heart disease is still the big boss of health problems in the US, and not in a good way Heart diseases are the leading cause of death for both men and women, claiming about 1 in 5 lives each year. Millions of Americans are walking around with risk factors, some they know about, some they don't. High blood pressure? That's more than 120 million adults. High cholesterol? Over 90 million. And then there's diabetes, obesity, smoking, stress, and sitting way too much. What's sneaky is how common it all is. You can be in your 40s, feeling 'fine,' and still have silent plaque building in your arteries. Lifestyle plays a massive role, processed food, too much salt and sugar, and not enough daily movement are basically an open invitation to heart trouble. The good news? Most of these risks can be lowered. Eat better, move more, keep your blood pressure and cholesterol in check, and quit smoking if you do. The heart might be complicated, but it also responds fast to healthier choices. In other words, you've got more control over your heart health than you might think—so start taking care of it now, not when the first scare hits. So what's the takeaway? Let's break it down: Physical activity as a canary in the coal mine When your movement starts tapering, especially consistently and long term, it might not be just busy life. It could be an early signal of strain on your cardiovascular system. And studying that decline gives us a huge head start to intervene. Keep moving, always Don't wait for a crisis. Starting good movement habits early isn't just about losing weight or staying fit, it's about keeping your heart talking to you softly, not screaming when it's too late. Tailored support matters Recognizing that not everyone has the same chances to stay active means we need targeted help, especially for those groups hit hardest: think community-friendly parks, local affordable classes, supportive healthcare advice that's tailored, not generic. Recovery isn't optional Once someone is diagnosed, getting back to movement, even slowly, is critical. Post-heart-event life doesn't mean sitting on the couch indefinitely. Unfortunately, the study found most people stayed below recommended activity levels even after a diagnosis Think of this like screening, not just with blood tests, but with lifestyle checks. If doctors, communities, and people start paying attention to when your activity starts to drop, that could become a real, actionable early warning sign. In short, the heart has a way of speaking quietly before it shouts. That gradual slowdown in your daily energy or activity? It might be worth listening to. Let's keep our bodies moving, not just for now, but for decades to come.
