Too young for a heart attack?
Let’s call him Mark. (Some details have been changed to protect his privacy.)
He was 34, a team leader at a call center, and a father of two. He worked the graveyard shift, kept himself awake with two or three energy drinks a night, and reached for his vape whenever the queue got heavy.
One early morning, near the end of his shift, he felt a heaviness in his chest. A burning sensation crept up his throat. He thought, “Hyperacidity na naman.” He took an antacid, finished his shift, and went home to sleep it off.
He woke up drenched in sweat, short of breath, and frightened.
By the time he reached the emergency room, the electrocardiogram told the story. Mark was having a heart attack. One of the major arteries supplying his heart was completely blocked.
Hypertension, diabetes, obesity and high cholesterol, once considered problems of middle and old age, are now showing up in people barely out of college.
He survived. But a portion of his heart muscle did not.
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When I asked when he had last had his blood pressure checked, he paused and laughed nervously. “Doc, I’m too young for that.”
The new face of heart disease
Mark is no longer an unusual patient.
When I was in training, heart attacks and strokes were diseases of our lolos and lolas. A patient in his 30s in the coronary care unit was a rarity, something residents talked about for weeks.
Today, it hardly raises an eyebrow.
Recent news reports have noted what many of us in practice already see: patients with chronic conditions are getting younger. Hypertension, diabetes, obesity, and high cholesterol, once considered problems of middle and old age, are now showing up in people barely out of college. And where these risk factors go, heart attacks and strokes eventually follow.
Having just celebrated World Stroke Day on Oct. 29, we should pay attention to this trend. Stroke and heart disease remain among the leading causes of death in the Philippines. When they strike young adults, the toll is doubly heavy. These are breadwinners, parents of small children, and workers at the peak of their productive years.
A stroke at 75 is a tragedy. A stroke at 38 can derail an entire family.
The usual suspects
Why is this happening? There is rarely a single culprit. More often, it is a gang of them working together.
The silent pressure. Hypertension is the leading risk factor for stroke, and it usually causes no symptoms at all. Many young Filipinos have elevated blood pressure and do not know it simply because nobody has measured it. Dr. Bimbo Diaz, current president of the Philippine Society of Hypertension, tells his audience at lay forums that you cannot treat what you have never checked.
The vape. Many young people have switched to vaping, believing it is the “safer” option. Safer than cigarettes, perhaps, but safe it is not. Nicotine raises heart rate and blood pressure, stiffens blood vessels, and makes the blood more prone to clotting. The sweet mango or grape flavor does not change what it does to your arteries.
The energy drink. One can of an energy drink on a sleepy afternoon is unlikely to hurt a healthy person. But several cans a day, often on top of coffee, can push heart rate and blood pressure up and, in susceptible people, trigger dangerous rhythm disturbances. Many are also loaded with sugar.
The stolen sleep. Our BPO workers keep the economy running while the rest of the country sleeps. But night shifts disrupt the body clock, raise stress hormones, and are linked to higher rates of hypertension, obesity and diabetes. Add long commutes and sleep debt, and the heart pays the price.
Then there is the familiar backdrop: fast food, sugary milk tea, hours spent sitting at a desk or behind the wheel, and stress that never takes a day off.
‘Baka pagod lang’
The most dangerous belief among young adults is not about vapes or energy drinks. It is the conviction that “this can’t be happening to me.”
So the warning signs get explained away. Chest discomfort becomes hyperacidity. Numbness in the arm becomes ngalay (a limb that has “fallen asleep”). Slurred speech is blamed on fatigue. “Baka pagod lang. (Maybe I’m just tired).”
Valuable hours are lost. In a heart attack, time is muscle. In a stroke, time is brain. Clot-dissolving treatment for stroke generally works only within the first few hours.
For stroke, remember BE FAST:
Balance. Sudden loss of balance or dizziness
Eyes. Sudden blurring or loss of vision
Face. One side of the face drooping
Arm. Weakness or numbness on one side
Speech. Slurred or strange speech
Time. Call for help and go to the hospital immediately.
For a heart attack, watch for chest pain, pressure, or tightness, especially if it spreads to the arm, jaw, neck, or back, or comes with sweating, shortness of breath, nausea, or a sense of doom. And yes, it can feel like acid reflux.
When in doubt, go to the ER. Being sent home with an embarrassing diagnosis of gas pains is far better than staying home with a dying heart.
What you can do now
The good news is that most heart attacks and strokes in young adults are preventable. Prevention, however, cannot wait until 50.
Know your numbers. Have your blood pressure, blood sugar, and cholesterol checked, even if you feel perfectly fine. A home BP monitor costs less than a month’s worth of milk tea.
Quit vaping and smoking. There is no safe level of nicotine exposure for your arteries.
Go easy on energy drinks. If you need three cans to survive a shift, the problem is not your energy. It is your sleep.
Protect your sleep. Shift workers, especially, should guard their rest hours with a dark, quiet room and a fixed schedule.
Move every day. Even brisk walking for 30 minutes most days makes a difference.
Know your family history. A parent or sibling who had an early heart attack or stroke means you need earlier and closer monitoring.
The bottom line
Mark is back at work now. He has quit vaping, sleeps properly on his days off, and takes his maintenance medicines faithfully. He also checks his blood pressure every week.
“I wish someone had told me sooner, Doc,” he said during a recent follow-up.
So let me say it now to every young reader who believes heart disease is a problem for later.
Later may come sooner than you think.
Youth is a gift, not a guarantee. Take care of your heart while it is still young enough to thank you for it.
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