A person can train at the gym, play sport every week, keep a healthy weight and still carry serious heart disease without realising it. That is the warning from UAE cardiologists, who say people in their 30s and 40s should not assume that being active is enough to protect them.
The message comes a day after World Heart Day, when hospitals across the country ran screenings and awareness events.
Fit on the outside, at risk inside
Dr Yogeeswari Vellore Satyanarayanan, a cardiology specialist at Medcare Royal Speciality Hospital, said that looking fit is not the same as being free of cardiovascular risk. She explained that high blood pressure, diabetes and cholesterol problems can stay silent for years, and that inherited conditions can raise risk even in people who exercise regularly.
She pointed to two in particular: familial hypercholesterolaemia and raised lipoprotein(a), known as Lp(a). Both can increase the chance of heart disease without obvious symptoms. Knowing your personal risk factors and getting the right checks can help doctors spot problems before a major cardiac event.
Patients who thought they were too young
Dr Hesham Tayel, a consultant cardiologist at International Modern Hospital, said he is seeing more patients in their 30s and 40s with significant coronary artery disease, some of whom appear completely healthy. Several arrived at hospital after a first episode of chest pain, only to learn they had severe blockages needing urgent treatment.
Some had been going to the gym regularly and believed they were too young for heart trouble. His conclusion is direct: a fit appearance does not guarantee healthy arteries.
Doctors say the risk factors behind these cases are varied. They include family history, smoking or vaping, diabetes, high blood pressure, chronic stress, poor sleep and inherited cholesterol disorders.
Why standard tests can miss things
One challenge is that routine cholesterol tests do not always tell the whole story. A person can have cholesterol levels that look normal while still having raised Lp(a), an inherited risk factor linked to heart attack and stroke. Doctors may also use an ApoB test to gauge the number of harmful cholesterol particles in the blood.
For selected patients, a coronary calcium scan can reveal early plaque in the arteries even when other results are reassuring. Dr Austin Mohan Komaranchath of NMC Specialty Hospital in Al Ain said that around 30 to 40 patients in his practice over the past year had abnormal calcium scores despite reassuring stress tests and echocardiograms. A stress test and a calcium scan answer different questions, he explained, so a clear result on one does not rule out plaque.
Many young adults are never screened
Dr Komaranchath said one of the biggest problems is that younger adults are simply not being checked. Blood pressure is often ignored, and some people who learn theirs is high do not take it seriously.
Some patients also fear that starting blood pressure medication means taking it for life. He said that fear can lead to years of uncontrolled pressure and damage to the arteries. He also cautioned against being satisfied just because cholesterol has fallen, since the question is whether it has reached the right level for each person’s individual risk.
Warning signs not to dismiss
Heart attacks do not always start with crushing chest pain. Dr Yogeeswari said some patients feel pressure or heaviness in the chest, while others develop breathlessness, sweating, nausea, dizziness or discomfort spreading to the arm, shoulder, back, neck or jaw. People sometimes mistake these signs for acidity, stress or tiredness.
Women may experience less typical symptoms, such as unusual fatigue, weakness, palpitations or dizziness. Anyone with these symptoms should seek urgent medical help and not wait to see if they pass.
What the doctors recommend
The specialists were careful to say they are not urging everyone in their 30s or 40s to undergo advanced heart tests. Their advice is more basic. People should know their blood pressure, cholesterol and blood sugar, understand their family history and talk to a doctor about their personal risk.
Readers with concerns about their own heart health should speak to a qualified physician, who can decide which checks make sense. Exercise remains one of the most important things a person can do for their heart, and the doctors’ point is that it works best alongside knowing your numbers.
