KARACHI: Nearly half of Pakistan’s heart attack patients are under the age of 49, with up to 15% younger than 40, cardiologists at the National Institute of Cardiovascular Diseases (NICVD) said on Saturday, warning of a sharp rise in early-age cases linked to diabetes, hypertension, obesity, smoking and unhealthy lifestyles.
NICVD’s Director of Cath Lab, Dr Abdul Hakeem, said Pakistan had “the highest rate of young heart attack patients globally.”
“Every third adult has diabetes, 40% have high blood pressure, obesity is common, and smoking rates remain high,” he said. “Many people don’t know they’re at risk because, in our culture, loose clothing hides weight gain. After the age of 30, everyone should get a cardiac check-up.”
Hakeem said nine in ten patients in NICVD’s data reported no severe chest pain, only heaviness or acidity-like discomfort, symptoms that can delay treatment.
“If you feel chest heaviness while walking or climbing stairs, get an ECG immediately,” he said. “The most dangerous anterior heart attack can damage up to 60% of the heart muscle and often causes a clot within four to eight weeks, increasing the risk of stroke.”
NICVD Executive Director Dr Tahir Saghir said the institute was moving into advanced research, including trials on drug-coated balloons that could reduce future artery blockages without stents, backed by international funding.
Senior cardiologist Dr Nadeem Rizvi stressed the value of locally conducted research tailored to Pakistan’s healthcare environment, while Dow Institute of Cardiology Director Dr Tariq Furman said genetic, socioeconomic and physical differences meant Western treatment guidelines often needed adjustment for local patients.
The findings were released alongside results from the country's largest clinical trial on acute left ventricular thrombus (LVT), a dangerous blood clot that can form after a severe heart attack and cause stroke.
Conducted by NICVD in collaboration with local pharmaceutical firm Pharmevo, the study compared rivaroxaban, a newer blood thinner, with the decades-old standard drug warfarin.
The trial, named RIVAWAR, ran from June 2021 to December 2023, enrolling 261 patients within seven days of a heart attack, most of whom had a severe form that also reduced heart function.
The study found rivaroxaban to be a safe, effective alternative to warfarin, with faster early clot resolution and similar success rates over 12 weeks.
Researchers said early diagnosis and treatment of LVT could prevent thousands of strokes in Pakistan each year.