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By Nutritionist Beatrice


A heart attack can occur at any age. Now, 1 in 5 heart attack patients are younger than 40 years of age. Many conditions or circumstances and behaviours that put people at risk of developing cardiovascular diseases (CVD) are appearing at younger ages:

  • Hypertension/High blood pressure, affecting 1 in 8 adults aged between 20 and 40 years is a major risk factor for heart disease. 
  • High cholesterol, mainly influenced by lifestyle factors such as diet and exercise habits can increase the risk for heart disease. 
  • Smoking damages the heart and blood vessels. A recent study found that young smokers were at least twice as likely as young non-smokers to die of a heart attack. Smoking was linked to earlier CVD onset and shortening a person’s lifespan by as much as four to five years1
  • Obesity can increase your risk of heart and circulatory diseases such as heart attacks, strokes and vascular dementia.
  • Diabetes mellitus is linked to many vascular problems.  People with Type 2 diabetes are 2 to 3 times more likely to develop CVD compared to people without diabetes. 
  • Sedentary lifestyle and physical inactivity are among the leading modifiable risk factors for CVD and all-cause mortality. 

Atherosclerosis and cardiovascular disease have a large impact on society. Atherosclerosis is a condition that occurs when a substance called plaque builds up in the walls of the arteries. The plaques are made up of cholesterol, fat, cellular waste product, calcium and fibrin (a clotting material in the blood). These buildups narrow the arteries, reducing blood flow and the supply of oxygen to the cells. When a blood clot forms, it can partly or completely block the flow of blood. Clogged arteries can lead to a heart attack or stroke.


What is Endothelial Dysfunction?

Endothelial cells coat the inner surface of blood vessels, forming a continuous lining called endothelium for the entire vascular system and play a key role in the maintaining homeostasis of circulation. Endothelial cells secrete vasoactive substances that cause relaxation (vasodilation) and contraction (vasoconstriction) of the underlying smooth muscle, thus controlling blood pressure. Endothelial cells also control blood clot and platelet adhesion as well as regulating immune and inflammatory reactions. Endothelial dysfunction is an initiative step in the development of atherosclerosis and appears to result from reduced levels of nitric oxide (NO) availability. Nitric oxide (NO) released by endothelial NO synthase (eNOS) causes smooth muscle cell relaxation and stops platelet aggregation and adhesion, thus contributing maintenance of vascular integrity. Oxidative stress has been shown to contribute to endothelial dysfunction and atherosclerosis progression. Some studies have demonstrated that phytonutrients and antioxidants can exert positive effects on endothelial function. 

Taking care of your heart should begin in your youth and continue throughout your lifetime. Getting regular exercise, following a healthy diet and quitting smoking can improve your overall health and reduce your risk of developing cardiovascular disease.





  1. Khan SS, Ning H, Sinha A, Wilkins J, Allen NB, Vu THT, Berry JD, Lloyd-Jones DM, Sweis R. Cigarette Smoking and Competing Risks for Fatal and Nonfatal Cardiovascular Disease Subtypes Across the Life Course. J Am Heart Assoc. 2021 Dec 7;10(23):e021751. 
  2. Hoo FK, Foo YL, Lim SM, Ching SM, Boo YL. Acute coronary syndrome in young adults from a Malaysian tertiary care centre. Pak J Med Sci. 2016 Jul-Aug;32(4):841-5. 
  3. Mohd Nor, N.S., Chua, YA., Abdul Razak, S. et al. Identification of cardiovascular risk factors among urban and rural Malaysian youths. BMC Cardiovasc Disord 22, 70 (2022).


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