'Heart disease rising among young people'

NICVD expert warns smoking, obesity and inactivity are raising heart risks

Heart disease is increasingly affecting younger Pakistanis, with smoking, physical inactivity, obesity and other modifiable risk factors pushing cardiovascular problems into age groups once considered relatively low-risk, a senior cardiologist has warned.

Speaking during a World Heart Day webinar hosted by The Express Tribune, Dr Fawad Farooq, professor of Interventional Cardiology at the National Institute of Cardiovascular Diseases (NICVD), said prevention must begin before symptoms appear because treatment alone cannot undo the damage caused by cardiovascular disease.

"Treatment alone is not enough," Farooq said, adding that diabetes, hypertension, obesity, inactivity and smoking can combine to significantly increase cardiovascular risk.

He said doctors in Pakistan are increasingly seeing serious cardiac problems among people in their 20s, 30s and 40s. Lifestyle patterns beginning in childhood—including reduced physical activity, poor diet, excessive screen time and early weight gain—are contributing to this shift.

Farooq expressed particular concern over smoking among younger people, saying some begin as early as 12 to 14. Unlike several other risk factors that develop gradually, smoking can also contribute to sudden cardiac events by increasing the tendency of blood to clot, he said.

Explaining smoking-related harm, Farooq distinguished between tobacco, nicotine and combustion. When a cigarette burns, he said, it produces smoke containing thousands of harmful chemicals that enter the body through the lungs and can damage blood vessels and other organs.

Nicotine, meanwhile, is not risk-free and is addictive, which can lead to dependence. Farooq said this dependence is often what brings smokers back to cigarettes even after they understand the risks associated with combustible cigarettes and the harms caused by smoke.

Farooq said complete cessation remains the preferred option, but acknowledged that long-term smokers may struggle to quit because of this dependence.

For those unable to stop immediately, he said harm-reduction approaches may form part of a structured quitting strategy under medical guidance.

Smoke-free alternatives are also available that can reduce exposure to the harmful by-products of combustion, which he identified as a major source of smoking-related harm.

He referred to nicotine gums, patches, heated tobacco and other non-combustible methods as options intended to reduce exposure to smoke and combustion while dependence is gradually managed. He stressed that such approaches are not for non-smokers and should ultimately support quitting.

Farooq also urged people to monitor blood pressure, blood sugar and cholesterol, remain physically active, maintain a healthy weight and avoid tobacco. "Try to keep your heart healthy while you are in health before developing disease," he said.