KARACHI: Pakistani researchers have launched two major long-term studies to determine why cardiovascular disease and heart attacks are increasingly affecting adolescents and young adults in the country, with experts warning that nearly 15 percent of heart attacks in Pakistan are now occurring in people below 40 years of age.
One of the studies, launched by researchers at Aga Khan University, will follow around 4,000 adolescents aged between 10 and 19 years from Karachi, Matiari and rural Sindh over the next 10 to 20 years to investigate how genetics, unhealthy diets, diabetes, obesity, smoking, pollution and lack of physical activity contribute to early cardiovascular disease.
At the same time, another nationwide study initiated by Tabba Heart Institute in collaboration with Getz Pharma will assess premature coronary artery disease and atherosclerosis among young Pakistanis.
Cardiologists say Pakistan is witnessing a dangerous rise in premature cardiovascular disease, with increasing numbers of people in their 30s and even younger ages developing blocked arteries, hypertension and heart attacks.
At Aga Khan University Hospital, renowned cardiologist and Vice Provost Research Prof Dr Salim Virani and his team have initiated what they describe as Pakistan’s first comprehensive long term cohort study focused on cardiovascular risks among adolescents and young people.
Known as the “Life Card Study”, the project aims to identify how environmental, metabolic and social factors beginning in childhood shape future cardiovascular health. Researchers will examine conventional risk factors including diabetes, hypertension, smoking, obesity and physical inactivity, while also studying air pollution, biomass fuel exposure, poor urban infrastructure, unhealthy food habits and genetic susceptibility.
Prof Virani said Pakistan was seeing cardiovascular disease at much younger ages compared to many Western countries, making urgent local research essential. “We are seeing heart disease developing at younger ages in Pakistan compared to many Western populations. This requires urgent scientific investigation because traditional risk factors alone may not fully explain the phenomenon,” he said.
Health experts say Pakistan already carries one of the world’s highest burdens of diabetes, while obesity, smoking, hypertension and sedentary lifestyles are rising rapidly, especially in urban centres.
They warn that worsening air pollution, chronic stress, sleep deprivation and dependence on processed foods are accelerating cardiovascular risks among younger people.
Karachi’s deteriorating air quality has emerged as another major concern, with international studies increasingly linking air pollution to inflammation, vascular damage and higher risks of heart attacks and strokes.
Prof Virani noted that many Pakistani adolescents are growing up in environments where safe public spaces for exercise are lacking, physical activity is declining and unhealthy diets are becoming more common.
Simultaneously, another major study titled “Pak Sehat” has been launched by Tabba Heart Institute and Getz Pharma to investigate premature coronary atherosclerosis among healthy young adults across Pakistan.
The 10-year nationwide cohort study will assess risks of atherosclerotic cardiovascular disease and identify early markers that may predict future heart disease before symptoms appear.
Principal investigator Dr Bashir Hanif of Tabba Heart Institute said the study would help identify individuals at risk at an earlier stage, allowing preventive interventions before heart attacks occur.
Researchers involved in the project noted that South Asians face nearly four times higher risk of atherosclerotic cardiovascular disease compared to several other ethnic groups, although the exact reasons remain unclear.
They warned that Pakistan’s cardiovascular risk profile was particularly alarming, citing estimates suggesting nearly half of Pakistani adults may have hypertension, while around 70 percent remain unaware of their condition.
Although both studies focus on premature cardiovascular disease, experts say the projects are complementary rather than overlapping. The Aga Khan University study is centred on adolescents and early life exposures, while the Pak Sehat project focuses more specifically on coronary artery disease and atherosclerotic risks among young adults.
International evidence has consistently shown that South Asians tend to develop cardiovascular disease almost a decade earlier than many Western populations, often despite having lower body weight. Scientists believe a combination of genetic predisposition, insulin resistance, abdominal obesity, chronic inflammation and environmental exposures may be responsible.
Cardiologists warn that unless preventive strategies are introduced urgently, Pakistan could face a major rise in premature cardiovascular deaths among working age adults, placing enormous pressure on families and the healthcare system.
They say findings from these long term studies could eventually help develop earlier screening guidelines, targeted prevention programmes and public health policies aimed at reducing cardiovascular disease among Pakistani adolescents and young adults.
