A growing body of medical opinion is shifting the focus of heart care from emergency treatment to early prevention. Dr Sanjay Bhojraj, a longevity medicine physician and board-certified interventional cardiologist, underscores this shift in his recent Instagram post, urging people to rethink when they should start paying attention to their heart health, ideally well before age 50.
Reflecting on his practice, he notes, “For 20 years, I was the cardiologist people came to after the system had already failed them,” highlighting a reactive healthcare model where intervention often begins too late. He adds, “After the blockage was there, the stent was needed, and the emergency was real. But the question that changed my career was: Why did we wait until the artery was already diseased to start calling this heart care?”
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According to him, the condition of your heart by midlife is not accidental but cumulative. “By 50, your heart is often reflecting the last 20 years of your metabolism, stress biology, sleep, blood sugar, inflammation, muscle mass, hormones, gut, and daily repair capacity,” he explains.
He also challenges a common misconception that the absence of symptoms equals good health. “The worst part? Most people are still being told they’re ‘fine’ because they don’t have any blatant alarm bells showing up yet. That is not prevention,” he says.
Instead, he advocates for deeper, earlier assessment:
“Prevention is knowing whether your body is building plaque before you feel symptoms.”
“It’s understanding whether your is damaging your vessels, even if you’re not diabetic.”
“It’s asking why your blood pressure is rising instead of only asking how to suppress it.”
While he acknowledges the importance of medical advancements, he emphasises a more proactive approach: “I still believe in modern cardiology. But I also know this: The best heart procedure is the one you never need.” He concludes with a call for earlier awareness, stating, “That is the conversation I wish more people were having before 50.”
Dr Bilal Ahmed Baba, Senior Consultant – Cardiology, Marengo Asia Hospitals, Gurugram, tells indianexpress.com, “Many cardiovascular problems develop silently for years before symptoms appear. Feeling “normal” does not always mean the heart and blood vessels are healthy. In many cases, risk factors show up long before chest pain, heart failure, or stroke develops.”
Some of the most important early markers, according to Dr Bilal include:
Several subtle changes can precede major cardiovascular disease:
“One of the earliest clues to declining is often not dramatic symptoms, but a gradual decline in stamina — ‘I can still do things, but not as easily as before,’” says Dr Bilal.
Heart disease prevention is usually far more effective than treating advanced disease later. Dr Bilal states the most powerful protective measures are often simple habits practised consistently over many years.
Aim for:
Even daily walking has significant cardiovascular benefits.
People in their 30s and 40s should periodically monitor:
Central abdominal fat and worsening metabolic markers often develop gradually and silently over time.
Poor sleep is strongly associated with:
Adults should aim for consistent, good-quality sleep and seek evaluation for symptoms such as loud snoring, excessive daytime sleepiness, or poor sleep quality that may suggest sleep apnea.
Chronic stress can contribute to elevated blood pressure, inflammation, poor sleep, unhealthy eating habits, and reduced physical activity.
Helpful strategies include:
Cardioprotective diets generally emphasise:
Dr Bilal mentions that even individuals who exercise regularly can be negatively affected by prolonged sitting. Frequent movement throughout the day matters.
“Avoiding smoking and limiting heavy alcohol intake are also among the most important long-term cardiovascular protective measures,” concludes the expert.
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