India accounts for about 60% of the global cases of heart disease despite having less than 20% of the global population, according to public health estimates. Not just this, but high rates of obesity and high blood pressure among younger people are putting them at risk for heart disease earlier in life: 50% of all heart attacks in Indian men occur under 50 years of age, and 25% of all heart attacks in Indian men occur under 40 years of age. Indian women have high mortality rates from heart disease too.
Unhealthy lifestyle practises, physical inactivity, obesity, and smoking are leading causes for young Indians falling prey to heart conditions. Coronary risks can be identified by a variety of risk markers; prevalence of diabetes, hypertension, and high levels of cholesterol are commonly used cardiac risk markers. However, most people are not aware of another independent risk factor for heart disease: high homocysteine levels in the blood.
Explaining the relevance of the homocysteine test, Dr Sameer Gupta, a US board-certified interventional cardiologist and Head of Cardiology for the Metro Group of Hospitals, shared, “Hyperhomocysteinemia is considered an independent risk marker for atherosclerotic vascular disease and venous thromboembolism or blood clots. But it is important to interpret the numbers in correlation with the patient profile and other risk factors. Increased levels of homocysteine are often secondary to nutritional inadequacy of folic acid and vitamin B12. It can be corrected with either supplements or a diet rich in fruits, vegetables, and low-fat dairy products.”
An analysis of data recently published by Tata 1mg Labs from about 3966 homocysteine tests conducted across its Delhi NCR lab testing facilities in the last two years indicates that 79.37% of people in Delhi NCR have higher-than-normal levels of homocysteine in their bloodstream, making them vulnerable to heart diseases such as blood clots, heart attacks, and strokes.
Interestingly, females fared much better than males in the test. While 27.18% of women had elevated levels of homocysteine, this figure was much higher for men at 52.19%.
The group of people below 25 years had the lowest incidence at 3.56% but rapidly climbed to the highest in the age bracket of 25–40 years at 41.58%. This was followed by the age groups of 40–60 years (about 38.18%), and above 60 years (16.71%).
Dr. Gupta cautions that, “Though a high level of homocysteine in the blood is a marker for increased risk, we do not have clear data that interventions to lower homocysteine will reduce the risk of heart disease.” If you have high homocysteine levels, your doctor may recommend taking vitamin B12, B6, or folate supplements. It is important to note that increasing your vitamin intake alone does not decrease the risk of heart disease; lifestyle corrections like smoking cessation, staying physically active, and managing your medical conditions hold crucial significance.
Dr. Prashant Nag, Clinical Head, Tata 1mg Labs, shared, “A homocysteine test may be ordered when your doctor suspects that you may have a vitamin B12 and/or folate deficiency. It can also be ordered as part of assessing the risk of heart disease or after a heart attack or stroke to help guide treatment. This test can be particularly useful for someone with a family history of coronary artery disease.” He adds, “While most labs consider normal homocysteine levels in the blood between 4 and 15 micromoles per litre (mol/L), any value above 15 is reported high. Excessive homocysteine levels, generally a level above 50 mol/L, may damage the lining of your arteries (blood vessels that carry oxygen-rich blood and nutrients throughout your body). It can also cause blood clots or artery blockages. Any clots or damage in arteries significantly increase the risk of a heart attack.”
It goes without saying that regular screening for risk factors and early detection of heart conditions is crucial to providing timely treatment and improving health outcomes. It would be prudent for every young adult not to relate heart disease with ageing and to be cognizant. Whether you are in a sedentary desk job or just started on highly intense exercise, gymming, or marathons, do get regular heart health evaluations.