Young hearts, growing risks: Why heart disease is no longer just an older person's problem

The heart is one of the most vital organs in the human body, yet it is often one of the most neglected, particularly by young people, who tend to associate heart disease with old age.

But that perception is changing. Cardiovascular disease (CVD) is increasingly becoming a concern among younger people in Bangladesh, with smoking, unhealthy diets, obesity, physical inactivity, stress and irregular sleep patterns contributing to a growing burden of cardiovascular risk.

"It has been well documented that cardiovascular diseases have increased alarmingly among Bangladeshi youth over the past decade," said Dr Amal Kumar Chowdhury, an interventional cardiologist and specialist in cardiology and medicine and professor at the National Institute of Cardiovascular Diseases and Hospital in Dhaka.

The Covid-19 pandemic also brought changes in people's lifestyles, including reduced physical activity, increased screen time and disrupted sleep, adding to existing health risks among younger people.

With World Heart Day observed on 29 September each year, health experts are stressing the importance of prevention and early intervention to reduce the risk of heart attack, stroke, heart failure and other cardiovascular conditions.

Why are young Bangladeshis at risk?

Smoking and the use of other tobacco products remain among the major cardiovascular risk factors among young people. These risks are compounded by unhealthy eating habits, alcohol consumption, drug use, obesity, chronic stress, inadequate sleep and increasingly sedentary lifestyles.

According to Bangladesh Bureau of Statistics (BBS) data from 2025, heart disease affects 31.32 people per 1,000 in Bangladesh. Hypertension affects 78.28 per 1,000, while diabetes affects 43.15 per 1,000.

Together, these conditions point to a significant cardiovascular risk burden across the country.

Family history is another important factor. People with a family history of high cholesterol, high blood pressure, diabetes or heart disease may face a higher risk of developing cardiovascular disease at a younger age.

But having these risk factors does not mean heart disease is inevitable.

Much of the risk can be reduced through preventive care and healthier lifestyle choices, particularly when these habits are established early.

The symptoms young people often ignore

One of the biggest problems is that young people may dismiss early warning signs as something less serious.

Chest pain or discomfort, for example, is sometimes attributed to gastritis or indigestion. But certain symptoms can indicate a potentially serious cardiovascular problem and should not be ignored.

Chest pain can feel like pressure, squeezing, heaviness, fullness or a sharp pain in the centre or left side of the chest. The discomfort may spread to the arms, neck, shoulders, jaw or upper abdomen.

Shortness of breath, with or without chest pain, can also be a warning sign. Other symptoms may include sudden cold sweating, nausea or vomiting, unexplained tiredness or weakness, a rapid or irregular heartbeat, dizziness or light-headedness.

Sudden lower-jaw pain without an obvious dental cause may also warrant attention, particularly if it becomes worse while walking and eases after stopping.

Some people may instead experience indigestion-like discomfort, including burning, fullness or discomfort in the upper abdomen or chest.

The intensity and combination of symptoms can vary from person to person. Anyone experiencing potentially serious or persistent symptoms should seek medical attention promptly rather than assuming they are caused by gastritis or another minor condition.

What changed during Covid?

The Covid-19 pandemic introduced additional lifestyle and health challenges for young people, although the available evidence does not establish a nationwide increase in youth cardiovascular disease caused by Covid-19 itself.

Before the pandemic, a study found that 9.7% of Bangladeshis aged 18–34 had hypertension, while another 33.4% had prehypertension.

During the pandemic, 43.7% of adolescents surveyed in one study reported weight gain, alongside increased screen time and sleep difficulties. Another rural study reported an increase in hypertension from 34.5% to 41.5% following the first wave of Covid-19.

Research has also examined cardiovascular complications among younger Covid-19 patients. One study reported a 60% mortality rate among younger patients with Covid-19 when considering severe cases and associated complications, including newly developed cardiovascular complications. Such findings, however, should not be interpreted as evidence that 60% of young people with Covid-19 died from cardiovascular disease.

The pandemic nevertheless highlighted how inactivity, weight gain, disrupted sleep and other changes in daily routines can affect long-term cardiovascular health.

Prevention has to start early

For many Bangladeshis, serious attention to health begins only in their 30s or later. But cardiovascular prevention needs to start much earlier.

"Preventive care and measures need to start early, before the age of 25," Dr Chowdhury said.

Regular physical activity is one of the simplest ways to protect cardiovascular health. Young people should aim for at least 30 minutes of moderate physical activity on most days, while gradually increasing the duration and intensity according to their fitness level and medical needs.

Diet also matters. For people who are overweight or have conditions such as diabetes or high blood pressure, reducing excessive intake of refined carbohydrates and highly processed foods can be beneficial. A balanced diet should include plenty of vegetables, along with appropriate portions of fish and other sources of protein.

People with a family history of high cholesterol, high blood pressure or heart disease may need to pay particular attention to their intake of foods high in saturated fat, including excessive amounts of red meat.

Dr Chowdhury also recommends fish as part of a heart-healthy diet, particularly because oily fish can provide omega-3 fatty acids. In Bangladesh, commonly eaten fish such as ilish and some smaller fish can contribute to dietary omega-3 intake.

Tobacco, meanwhile, should be avoided altogether. Smoking and other tobacco products are among the most important preventable cardiovascular risk factors. Vaping should not be treated as a harmless alternative.

Fast food and takeaway meals can also contribute excessive amounts of salt, sugar and unhealthy fats when consumed frequently. Sugary soft drinks are another concern. A 500ml bottle of a typical cola drink can contain roughly 50–55g of sugar, equivalent to around 12–13 teaspoons.

Reducing their consumption can therefore be an important part of improving the overall diet.

Know your numbers

Prevention is not simply about changing what is on the plate or how much one exercises. Regular health checks can help identify risks before they develop into serious disease.

Monitoring blood pressure, blood glucose and cholesterol is particularly important for people with a family history of cardiovascular disease or other risk factors. People with diabetes, hypertension or high cholesterol should follow medical advice on how frequently they need screening and treatment.

Heart disease may no longer be something that only happens to older people, but neither is it an unavoidable consequence of getting older.

For Bangladesh's young population, the most effective time to start protecting the heart is long before the first warning sign appears.