Reframing Heart Health: The Urgent Need For Early Detection Of Heart Failure In India

The term ‘heart failure’ does not mean that the heart has suddenly stopped functioning. It is a progressive, complex condition where the heart gradually loses its ability to pump blood effectively. Over time, this leads to symptoms such as fatigue, breathlessness, fluid retention, and, if left unmanaged, frequent hospitalisation and premature death.

Traditionally, heart failure has long been associated with elderly population, but in India, reality points to a very different and more pressing challenge. Unlike in the western countries where the disease typically manifests after the 70s, in India, it tends to strike nearly a decade earlier, often beginning between 40 and 60 years of age. This earlier onset means prolonged illness, repeated hospitalisation and greater financial and emotional strain on families at the very stage of life when people are most economically active.

Why Heart Failure Cases Are Rising in India

According to Dr VT Shah, Senior Consultant Interventional Cardiologist, Mumbai, “The reasons for this shift are multiple and interconnected. India’s rapid economic growth, industrialisation, and urbanisation have led to a profound shift in how people live, work, and eat. Lifestyle factors like unhealthy diets, high levels of salt intake, physical inactivity, alcohol consumption, and tobacco use, all contribute to an increased burden of diabetes, obesity, and hypertension, all of which are strongly linked to the development of heart failure.”

Can Diabetes Cause Heart Failure

Diabetes alone changes the trajectory significantly. Among Indians, its onset is nearly a decade earlier than in many other countries. People living with diabetes develop heart failure at younger ages with more severe forms. They are also more likely to be admitted to hospital for heart failure once it occurs. With over 101 million Indians living with diabetes, and more than half undiagnosed, the pool of people at risk is enormous.

Hypertension and Heart Failure Link

“There is also a young-age prevalence of hypertension in India. High blood pressure, even without other heart diseases, damages the heart muscle over time and hampers its functioning, thus increasing the risk,” shares Dr Shah.

Also Read: What Is The 5-Second Leg Test That Can Help Detect Heart Failure

Risk and Complications

This growing prevalence of heart failure is alarming as the complications are severe and long-term in young adults. Patients often endure frequent hospitalisation, diminished quality of life and rising healthcare costs. The outcomes of heart failure in younger adults are particularly poor due to delayed diagnosis and inadequate management.

The risk does not end with the first admission. Rehospitalisation rates are especially high within the first three months to a year after an initial episode and with each subsequent hospital stay the outlook becomes poorer. Over time, the chances of survival decline sharply, with five-year outcomes in heart failure proving to be as bleak as those seen in many cancers. The term ‘worsening heart failure’ is used for such patients who have to visit the emergency room/hospital for worsening symptoms despite the treatment.

Late Diagnosis of Heart Failure

According to Dr Shah, “Heart failure is often diagnosed late because its early symptoms such as fatigue, swelling in the legs, or shortness of breath can be mistaken for signs of other conditions like obesity. This similarity leads to underdiagnosis or misdiagnosis, meaning patients are frequently identified at more advanced stages where the condition requires aggressive treatment.”

Also Read: Is Swelling In The Feet A Sign Of Heart Failure? Here’s When To Be Concerned

This reality underscores the need to reframe the conversation on heart health in India. There should be greater emphasis on early screening and timely intervention. For high-risk groups, such as people living with diabetes, obesity, or a family history of heart disease, proactive cardiac evaluations should begin earlier in life rather than waiting for symptoms to appear.

Why Is Early Diagnosis Important?

Early diagnosis can make a lot of difference, because once identified, heart failure can be managed, and its progression can be slowed. There are advanced therapies available for worsening heart failure patients to reduce frequent hospitalizations and the risk of death.
Alongside screening, preventive steps play a critical role. Lifestyle changes such as balanced diets, regular exercise, avoidance of smoking, and stress management could help maintain heart health.

Final Word

It is time to educate those most vulnerable and emphasise the importance of early detection, targeted prevention strategies, advanced therapies and multidisciplinary management approaches to address this alarming trend.

References:

• https://pmc.ncbi.nlm.nih.gov/articles/PMC11322948/#:~:text=Smoking.%20Another%20challenge%20many%20South%20Asian%20countries,class%20in%20India%2C%20Bangladesh%20and%20Sri%20Lanka.
• https://pmc.ncbi.nlm.nih.gov/articles/PMC5992798/#:~:text=The%20admission%20rate%20and%20readmission,homeostasis%20all%20the%20more%20precarious.&text=Even%20patients%20with%20prediabetes%20carry,for%20hospitalisation%20for%20heart%20failure.&text=But%20with%20diabetes%2C%20that%20risk,patients%20with%20established%20heart%20disease.
• https://pmc.ncbi.nlm.nih.gov/articles/PMC5494155/#:~:text=Diabetes%20in%20Patients%20with%20Heart,ischaemic%20or%20non%2Dischaemic%20origin.