Many people think of heart disease as a problem for older adults. In reality, the risk can build silently for years, even in people who look healthy, exercise regularly and keep a normal weight.
A silent buildup that can start early
Atherosclerosis, the buildup of plaque in the arteries, can begin as early as childhood and progress silently for decades. In its early stages, plaque may not restrict blood flow enough to cause symptoms. But if a plaque ruptures, it can trigger a heart attack without warning.
For some people, the first sign of coronary artery disease is a serious cardiac event. This is why risk assessment should not wait until chest pain appears.
Adults in their 30s and 40s can develop significant coronary artery disease even with a healthy lifestyle. Contributing factors include metabolic issues, smoking, abdominal obesity, poor sleep, prolonged sitting and family history. High cholesterol and high blood pressure are also common, and often cause no symptoms at all.

Look beyond cholesterol
Cholesterol matters, but it is only one part of the picture. I recommend keeping track of:
- Blood pressure
- Blood sugar or HbA1c
- Waist circumference
- Kidney function
- Smoking status
- How much you exercise
- Your family history
A normal body weight does not rule out metabolic risk. Eating ultra processed food, sitting for long periods, poor sleep, chronic stress, and smoking or vaping all add to your risk, even if you exercise regularly.
Who should get checked
In general, adults over 40 should consider cardiovascular risk screening. If you have a family history of heart disease or other risk factors, you may need an assessment earlier.
The goal of screening is not to hunt for disease indiscriminately. It is to catch modifiable risk factors early, treat them appropriately and prevent heart attacks or strokes.
Prevention does not require drastic change
Protecting your heart does not mean overhauling your whole life. Quitting smoking, cutting down on salt and sugar, staying active and spending less time sitting are sustainable steps, alongside medication where needed.
Your heart works for you every day. Do not wait for symptoms before giving it the attention it deserves.
Medical Disclaimer
This article is intended for general education and awareness purposes only and does not constitute medical advice, diagnosis or treatment. Individual symptoms and medical conditions may vary. Please consult a licensed medical practitioner for appropriate assessment.
For more information about Dr Joshua Loh and his medical practice, visit CapitalHeart.sg or contact Beyond Medical Assistance (Philippines) via WhatsApp at (63) 956 0655 717