Prevention of Coronary Artery Disease

CAD is substantially preventable - and for Indians, prevention starts a decade earlier than the textbooks written elsewhere suggest. The strategy is simple to state and lifetime-long to practice: protect the arteries before plaque builds, or at least before it ruptures.

Know your numbers (from age 30, or earlier with family history)

• Lipid profile: LDL cholesterol is the target - under 100 for most, under 70 for those with established CAD or diabetes
• Blood pressure: under 130/80 as the modern goal; home monitoring helps
• Blood sugar: fasting and HbA1c; prediabetes is the reversible warning
• Waist: under 90 cm for men, 80 for women (Asian cutoffs) - belly fat is the Indian signature risk
• Family history written down: it changes when and how hard to screen

The daily protections

• Do not use tobacco in any form - smoking and gutkha both count; quitting cuts risk within a year
• Move 30-40 minutes daily: brisk walking is enough; the heart is a muscle that trains
• Eat the heart plate: vegetables-dals-whole grains forward, fried-salt-sugar backward
• Sleep 7 hours; chronic short sleep and untreated snoring (sleep apnea) both strain the heart
• Manage stress: not a soft extra - chronic stress measurably raises events

The medical layer

• Statins for prevention when risk scores justify them (diabetes, high LDL, strong family history): a doctor's calculation, not self-medication
• Treat BP and diabetes to target, not to "almost"
• Regular check-ups: annual after 40 with any risk factor; an ECG and discussion of stress testing or CT calcium scoring for higher-risk people

The Indian reality check

A 35-year-old with a pot belly, desk job, biryani habit and a father who had a stent at 50: that is the person prevention is for. The first heart attack in such families often arrives unannounced - make yours announced by a check-up instead.

One-line summary

Prevent CAD by knowing your LDL-BP-sugar-waist numbers from 30, quitting tobacco, walking daily, eating the heart plate, sleeping enough - and treating family history as a reason to start early, not to worry late.