A few months ago, a 45-year-old man from Kathmandu was admitted to a private hospital for a minor ailment. Doctors told him he was recovering well and that he would be discharged soon.

On the afternoon of the day he was supposed to be discharged, the patient had an argument with his wife and he lost his cool, said Dr Om Murti Anil, a senior cardiologist who attended to him. “Immediately after, he complained of uneasiness in his chest. Then he lost consciousness,” Anil told the Post.

According to Anil, an electrocardiogram showed an arterial blockage in his heart. “We had to perform an angioplasty to remove the blockage,” said Anil.

This case is not unique, however, according to doctors, as people who usually look fit and fine, do regular exercise and are conscious about their health and food habits have been found to be increasingly suffering from heart diseases these days.

“Though there are no detailed studies in the country yet, people seem to be less aware of cardiac risks due to negative emotions—anger, hatred, sadness, mental stress, anxiety and depression,” said Anil.

The World Health Organisation says cardiovascular diseases kill 17.9 million people every year, 31 percent of all global deaths. Eighty-five percent are due to strokes and heart attacks.

According to a study on Nepal Burden of Disease conducted in 2017, ischemic heart disease—related to the narrowing of arteries—accounts for 16.4 percent of the country’s total deaths.

Changing age structure and lifestyle—increasing sedentary behaviour, tobacco and alcohol use, and unhealthy diets, high cholesterol level, obesity, physical inactivity, stress, and diabetes—are said to be the leading causes for the rise in non-communicable diseases, including cardiovascular diseases.

According to Anil, psychosocial and behavioural factors are also associated with cardiovascular diseases, but people tend to ignore them.

"When one becomes angry, his/her blood pressure spikes, which tightens blood vessels, resulting in clotting,” said Anil. "When one has negative feelings all the time, stress hormones flood the bloodstream, affecting the heart and other vital organs."

Cardiovascular diseases are disorders that affect the heart and blood vessels. Coronary heart diseases, deep vein thrombosis and congenital heart disease are common conditions. But strokes and heart attacks are acute incidents, which are triggered by a build-up of fatty acids in blood vessels that block blood flow to the heart or brain.

“In urban centres, where people may look quite conscious about their health and food habits, due to intense stress associated with responsibilities at home or work or multiple roles, they at times cannot control their behaviour,” said Anil. “And this can be dangerous.”

Doctors agree that despite the fact that cardiovascular diseases are on the rise, there continues to be confusion among people as to how to prevent them, and at times there is negligence on the part of people.

“Behavioural change is key,” said Dr Shivaji Bikram Silwal, a consultant cardiologist at Norvic International Hospital. “Even though people are aware of the consequences of neglecting their health, they are reluctant to change their behaviour. And, more than the diseases, it is negligence that kills.”

According to Silwal, many people do not go for routine health check-ups despite knowing they are at risk.

At times, people mistake heart problems with normal pain, like gastritis or heartburn.

“When a 38-year-old patient visited my clinic recently, he told me he was having chest pain for the last three days. But he thought it was due to gastritis. He came to me only after the pain became intense,” Silwal told the Post. “He fell at the door while waiting for his turn. He was rushed to a private cardiac care facility where doctors opened his blocked right coronary artery.”

Doctors say that in recent times, people as young as 30-year-olds also are found to have been suffering from some sorts of heart problem.

Among the patients of high blood pressure, diabetes or high cholesterol levels Anil examines each day, at least 10 are younger than 30.

“There is no doubt people need to pay more attention to their diets and exercise,” said Anil. “But they also need to avoid situations that could trigger intense confrontations to prevent the risk of heart attacks.”