India, July 1 -- Increasing cases of coronary artery disease (CAD), heart attacks, strokes and even blood clots in the legs have surfaced over the years. Given the global focus on how environmental factors impact various facets of life, it would not be out of place to mention that pollution, particularly air pollution, is one of the most underappreciated risk factors in heart ailments. Many people are still unaware that the air we breathe directly affects our heart. Tiny particles suspended in polluted air-what we call particulate matter or PM - can go deep into lungs and even enter our bloodstream. Once inside, these particles can wreak havoc by damaging blood vessels, inflaming tissues and contributing to a cascade of harmful effects on the heart, lungs and vascular system. Globally, more than 3.5 million people die each year from heart disease. Shockingly, around 31% of these deaths happen in India alone. Nearly one-third of first-time heart attacks occur in people under 45, according to data from a global study by the World Heart Federation. In fact, about 45% of all heart-related deaths happen in individuals aged 40 to 69, what we consider the most productive years of life, data from the same study showed. So how exactly does polluted air lead to a heart attack? The science is quite clear now. These fine particles, once inhaled, enter the bloodstream and begin to damage the inner lining of our blood vessels. Over time, this damage causes the vessels to narrow and harden-a condition known as atherosclerosis. This leads to high blood pressure, increases the chance of clot formation, and can even disturb the normal rhythm of the heart, known as arrhythmia. All three of these-blockages, clots, and rhythm disturbances-can lead directly to heart attacks or strokes. In many reviews, which have also looked at regional patterns and found that areas with high levels of pollution also report higher incidences of cardiovascular disease. Long-term exposure makes blood vessels stiff and reduces blood flow, raising blood pressure and significantly increasing the risk of sudden cardiac events. But pollution isn't limited to the air. We're now dealing with traffic-related pollutants, noise pollution, contaminated water, pesticide-laden food and heavy metals in our soil. These are all contributors to cardiovascular risk. In a study conducted at SGPGIMS with over 600 patients, doctors found some interesting statistics about premature heart disease. Among those with early-onset heart attacks, 20% were hypertensive, around 33% had diabetes, and 10 to 15% were under 40 years old. Nearly 28-38% were smokers, and over 50% had dyslipidemia-a serious imbalance in their cholesterol levels. What's more, lifestyle and genetic factors are also playing a role in younger patients. Smoking, diabetes, high LDL cholesterol, and elevated Lipoprotein(a) levels are all increasingly common in those under 45 who suffer heart attacks. Despite all this, I remain hopeful. With greater awareness and commitment to preventive care, we can reduce the burden of heart disease. On the policy level, we need renewable energy adoption, stricter emission norms, better urban planning to reduce pollution, and tighter regulations on chemical exposure. On an individual level, lifestyle plays a major role. Avoiding junk food, quitting smoking, exercising regularly, managing blood sugar and cholesterol, and monitoring blood pressure can go a long way-especially for our younger generation. At the recent 76th Conclave of the Cardiological Society of India in Lucknow, I was heartened to see that experts from across the globe echoed these concerns. Countries like the UK are already taking major steps, aiming to prevent 50,000 new cases of heart disease by 2035 simply by improving air quality. We need a similar commitment here in India. The link between pollution and cardiovascular disease is no longer speculative; it's a proven threat. The time to act is now. Dr Satyendra Tewari is a professor at the department of cardiology, SGPGIMS, Lucknow. Currently, he is serving as the vice president of the Cardiological Society of India....