Regular Exercise and Normal Weight Don’t Rule Out Coronary Artery Disease in Your 30s
This article is based on information shared in Lianhe Zaobao (联合早报), featuring Dr Joshua Loh, Senior Consultant Interventional Cardiologist and Medical Director at Capital Heart Centre.
Cardiovascular disease isn’t just a concern for older adults. The risk can build silently for years, even in people who appear healthy, exercise regularly, and maintain a normal weight. With World Heart Day falling on 29 September, doctors are urging the public to pay closer attention to heart health and early prevention.
Silent Plaque Buildup Can Start Early
Dr Joshua Loh, Senior Consultant Interventional Cardiologist and Medical Director at Capital Heart Centre (part of Beyond Medical Group), notes that ischaemic heart disease remains Singapore’s third leading cause of death, and roughly one in three residents has high cholesterol, high blood pressure, or both, often without symptoms. Adults in their 30s and 40s can develop significant coronary artery disease even with a healthy lifestyle, due to factors like metabolic issues, smoking, abdominal obesity, poor sleep, prolonged sitting, or family history.
Atherosclerosis, the buildup of plaque in the arteries, can begin in childhood and progress silently for decades. Early plaque may not restrict blood flow enough to cause symptoms, but plaque rupture can trigger a heart attack without warning. “The first sign of coronary artery disease can sometimes be a serious cardiac event,” Dr Loh says, adding that risk assessment shouldn’t wait until chest pain appears.
What to Monitor Beyond Cholesterol
Dr Loh recommends monitoring blood pressure, blood sugar or HbA1c, waist circumference, kidney function, smoking status, exercise levels, and family history. A normal body weight doesn’t rule out metabolic risk. Lifestyle factors like ultra-processed food intake, prolonged sitting, poor sleep, chronic stress, and smoking or vaping all contribute, even in people who exercise.
Who Should Get Screened
Under Singapore’s Healthier SG programme, adults over 40 without a history of high blood pressure, diabetes, or high cholesterol are generally eligible for cardiovascular risk screening, while those with family history or other risk factors may need earlier assessment. “The goal of screening isn’t to hunt for disease indiscriminately, but to catch modifiable risk factors early, treat them appropriately, and prevent heart attacks or strokes,” Dr Loh says.
Prevention Doesn’t Require Drastic Change
Quitting smoking, reducing salt and sugar, staying active, and reducing sedentary time are sustainable steps, alongside medication where needed.
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https://www.zaobao.com.sg/lifestyle/health/story20260922-9690791