‘How Stress is Killing you Slowly’- is a super guest post by Dr Mani, India’s very famous Heart Surgeon. Besides being a Heart surgeon, he is an Author, social entrepreneur, & a Fund raiser too. Dr.Mani juggles many roles in pursuit of his dream – to make heart healthcare accessible to every Indian child. His non-profit has sponsored life-saving treatment for 147 ‘Heart Kids’, with many more to come.

As a trainee cardiovascular surgeon, I saw heart attacks almost every day. What’s changed over the years is the age of these patients, how young they are today.

Back when I was in medical school, it was rare to have anyone under age 60 in the cardiac ICU. A couple of decades ago, we saw a growing section of middle-aged 50 year-olds suffer from heart problems. And now, scarily, it isn’t unusual to have young patients in their 30s and 40s admitted for stress-related cardiac conditions.

The data is convincing, condemning and of deep concern.

Between 2001 and 2003, 26%  adult deaths in India were caused by heart disease. By 2010-2013, this had ballooned to 32%.1

Premature mortality from cardiovascular disease (CVD) in India increased by 59%, going up from 23.2 million (1990) to 37 million (2010). 2

What has happened to create such a shift?

And what can you do to cope with this new scenario?

Finding out could be life-saving. Quite literally.

So pay close attention to this story…

How An Old Lady Taught Me A Powerful Lesson About Health And Fitness

I was twenty-eight years old. In the pink of health. At peak fitness. And I was halfway through residency training to be a specialist heart surgeon.

Our operating suite and ICU were on the 5th floor. Often, the lifts were out of service. So I’d climb up and down the stairs a few times daily. I was returning from the blood bank one afternoon when I noticed a lady a few steps ahead of me.

She was clearly a villager. In her late 50s or early 60s. Wiry and tough, a faded cotton saree draped around her thin frame. She set a brisk pace. I followed, hoping to pass her on the next floor when she tired.

By the time we reached the third floor, she was still climbing steadily at the same speed. We arrived at the next landing, and then at the 4th floor. I was breathing hard by then.

She was still a few steps in front!

I tried to speed up to overtake her, but couldn’t muster the extra bit of stamina. Before I stepped into the corridor on our 5th floor, I glanced at this amazing lady – who was going at the same speed up to the 6th, towards the Cardiology ICU.

To this day, she’s the role model of fitness and health that I strive to match. At 60, if I too can climb five flights of stairs faster than a guy or gal half my age, I’ll consider myself fit!

What’s The Secret To Living Not Just Long, But Healthy Lives?

There isn’t any secret, really. Just common sense. Your level of well-being mirrors three simple but important indicators of good health:

  • What you eat
  • Fitness
  • Stress

We could spend all day talking about healthy eating habits.

Fast food is quick and cheap. In a world that’s moving at warp speed, where we have little time for anything at all, grabbing a quick bite to eat is convenient. Except, it isn’t quite healthy.

Once in a while, it doesn’t matter. But make it your regular lifestyle, and the health consequences begin to loom dangerously in the distance.

In fact, consistently eating anything that comes out of a carton or package isn’t healthy. Processed foods are largely responsible for the epidemic of so-called “lifestyle diseases” – heart attacks, diabetes, high blood pressure, obesity and more.

Okay, you’ve heard all this before. But seriously… how bad can the situation be, right?

Well, pretty bad, to be honest! Just look at these shocking facts:

a) We’re diabetic. A mind-numbing 65.1 million Indians have diabetes… and this is set to increase to 101 million by 2030. Over the last 20 years, diabetes prevalence has doubled, going from 9% to 17% in urban areas… and more than quadrupled in rural areas, from 2% to 9%.

b) We’re hypertensive. Three of every ten adult Indians suffer from high blood pressure. This number is expected to double – from 118 million in 2000 to 213.5 million by 2025.

c) We’re dyslipedemic. Across all social groups, blood levels of ‘bad’ LDL cholesterol and triglycerides have risen rapidly. In a large population survey, only 1 in 5 people had normal lipid levels.

d) We’re lazy. Just 1 in 10 Indians engage in recreational physical activity – and 1 of every two individuals is physically inactive.3

And these are all problems. Stress is Killing you. Slowly. And literally.

Your level of fitness is just as important as what you eat, if you’d like a long, healthy life. More than enough research exists to prove that a sedentary lifestyle without exercise and activity is a recipe for various illnesses.

Here are 7 steps to a healthier heart 4. Simple, everyday things you can do to ensure your heart stays in good shape and keeps you running well.

how to keep your heart healthy

7 Steps to a healthy heart (4) (Infographic courtesy: American Heart Association)

Hence the recommendation to keep moving – Don’t walk if you can run. Don’t stand if you can walk. Don’t sit if you can stand.

But although it’s easy to recommend half an hour of walking, jogging, cycling or other aerobic exercise at least 4 times a week for heart health, even this is quite tough to squeeze into a hectic work schedule.

That’s why you need ‘cheats’ and ‘hacks’.

– Like not taking a bus or car for any trips shorter than a kilometer – but walking instead.
– Or getting off the bus or train a stop before your destination – and doing the extra block or two on foot.
– Or climbing up and down one or two flights of stairs instead of getting on the lift.
– Or standing at your desk while working (like I’m doing now, as I write this article!)

It’s how you can fit some fitness into your busy life.

Surprisingly, what continues to remain a secret to many is that stress is a bigger risk factor for heart attacks, hypertension, strokes and several other illnesses – than anything else!

healthy heart

(Image courtesy: Pixabay)

Are You Suffering From Stress?

Almost everyone I’ve asked this question answers immediately: “No, no doctor. No stress.”

That’s because “stress” is easily the most misunderstood concept.

To many, a person under stress must fit a stereotype – a maniacal red-faced man, screaming his head off as he stomps around a room, taut and angry, his voice shaking with rage. Because they themselves don’t behave this way (at least not too often!) these people believe they are not under stress.

But from a health standpoint, stress can wear many disguises. That’s why it is often a ‘silent killer’. Let me put it this way…

If you’re alive, but claim to have “no stress”, I’ll call you a liar!

Everybody who is breathing has stress in their lives. Stress is killing you all, if you don’t acknowledge it. 

In my operation theater, where I perform heart surgery on little kids, I depend on some twenty different people on my team. Each one is responsible for dozens, even hundreds, of tasks in the course of a procedure. And they are all critical tasks.

If anyone makes a mistake, it could risk a child’s life. There’s not much room for error in my specialty.

Do I work under stress?

You bet I do!

My mother is eighty years old. She retired from medical practice 20 years back. We still have lunch or dinner together every day. And she talks about things that worry her.

The hose she uses to water our garden is leaking. The living room floor needs to be repaired. Her hearing is growing worse, and she needs a new hearing aid.

Does she face stress?


And (to her) the stress is of the same high level as mine!

It doesn’t matter whether you’re a housewife or corporate executive, a delivery boy or college student, a taxi driver or security guard, an entrepreneur or share trader, a heart surgeon or retiree… you are under stress.

But that’s NOT the problem.

No. Then…

If Stress Itself Isn’t The Problem, What Is?

What matters is how you deal with stress. The things you do to cope. How you adjust and come to terms with it.

There are healthy ways to tackle stress. And there are unhealthy ways. The first is good. The second is bad.

So, how to distinguish between them?

If the way you handle stressful situations leaves you feeling calm, empowered, even happy, then it is healthy. On the other hand, unhealthy adaptations to stress leave you anxious, exhausted, frustrated and angry.

Imagine that you have a demanding boss at work, or a strict disciplinarian teacher at school, or a nitpicking professor in college… someone who keeps on criticizing you, complaining about you, putting you down.

You have stress in your lifebecause of this person.

You can choose to deal with it in different ways.

– You could try and do whatever she wants you to – and see if the bickering stops.
– Or you could just cut him some slack… after all, maybe he’s got something going on in his life that’s making him mad – and he’s just acting it out with you.
– Or you could decide to ignore everything she says, and focus on doing your thing to your best ability.

All of these would leave you calm, composed and balanced. The stress still exists – but is under control.

But you might also decide to react another way.

a) You might get angry and defensive – and argue with him about every accusation or critical remark.
b) Or you might keep quiet, but simmer within at her arrogance and audacity at scolding you.
c) Or you might start believing that you’re really not good at all, and let the negativity actually pull you down, making your performance even worse than before.

All of these would increase your level of stress – and eventually, lead to health problems.

The specific details will vary depending on your circumstances. But by assessing how you feel while dealing with stress, it is easy to tell if your approach is healthy – or not.

And unhealthy adaptation to stress has several unpleasant consequences.

It raises your blood pressure. Causes body aches. Releases harmful stress hormones (like adrenaline and cortisol) that lead to biochemical imbalance, resulting in conditions like diabetes and obesity. In a psychologic sense, stress affects your mental balance, alters your personality, and destroys your peace of mind.

In modest quantities and for limited periods, stress can be helpful. It keeps you alert and on your toes during an important interview or examination. It can bring out your best effort in a competition or fight. But if it continues for prolonged durations, stress can be a killer.

effect of stress on the heart

(Image courtesy: Mel Magazine)

How Can You Cope With Stress?

There’s a long list of things you can do to handle stress – healthily.

1. Have Fun

The best way to beat stress is to have fun. A favorite quote of mine goes: “If you do what you love, you won’t have to work a single day in your life.”

No, that doesn’t mean you idle away the rest of your life. It’s just that when you’re having fun, even the hardest chores don’t feel like work!

A typical paediatric heart operation lasts anywhere between 4 and 12 hours. At the end, though I’m physically tired, my mind is alert, active, agile… and ecstatic. Because I love the thrill and challenge of my work.

So to beat stress, have fun.


– Find a job you enjoy.
– Work with people you like being around.
– Take short breaks from work. You’ll return refreshed and energized for more.
– Pursue a hobby. Anything you find stimulating.
– Build positive, nurturing relationships.
– Work with passion, and towards a purpose.

2. Stay Healthy

Stress will wear you down more easily if you’re not fit and healthy. It’s a vicious cycle.

More stress -> Less health -> Even more stress.

A great approach to stress management is to improve your physical health and fitness. All it takes is to make a few small changes to the way you live.

– Get enough sleep at night.
– Eat healthy food (because hunger increases stress).
– Drink plenty of water.
– Quit smoking.
– Drink alcohol only in moderation.
– Exercise regularly.

3. Set Goals

“I am the master of my fate,

I am the captain of my soul.”

Invictus, by William Ernest Henley

If you don’t know where you’re going, how will you know when you get there?

Too many people are stressed because they’re running on a treadmill. Working hard, getting nowhere – in a hurry! No wonder they experience so much stress.

It helps when you set yourself targets to achieve. To have an idea of what your life should be like, where you’d like to go, the things you want to accomplish, achieve and attain. In other words…

You Should DREAM!

And then, draw up plans to make those dreams come true. When your efforts align with your passion and purpose, there’s no place for stress in your life.

“If you dream it, you can do it.”Walt Disney

Where can you begin?

– Decide upon the right priorities.
– Manage your time well.
– Be organized and make plans.
– Don’t take on too many tasks. Learn to say ‘No’ to non-essentials.
– Avoid a last minute rush to meet deadlines.

4. Take Control

“A healthy outside starts from the inside.” Robert Urich

While all the other methods are external, the most important element of stress control lies inside you. In changing your attitude to your life, work, circumstances and environment.

Because as long as they are in conflict, your stress will continue to build.

An important reason you’re stressed is because you believe you’re not in charge. That things are out of your control. You feel helpless. At the mercy of someone or something else.

It’s time to take back control.

Of your thinking. Your attitude. Your belief. Your mind.

– Read inspiring books, quotes and poems.
– Practice meditation. Spend quiet time with yourself.
– Learn yoga.
– Try tai-chi to lower stress and calm yourself down effectively.

You can’t always change what’s around you. But you always can change your reaction to it. And that’s often what is necessary to cope with stress effectively.

If you’re tempted to brush this aside, or tell yourself it’s too difficult to change, remember – unless you manage stress, you’re likely to become another statistic in the rising epidemic of life-threatening heart conditions that are caused by our high-stress lifestyle.

You can either change today – and prevent a health disaster.

Or you’ll be forced to change soon – after facing and overcoming one.

Trust me, prevention is 100 times better than a cure. And coming from a heart surgeon, this should scare you into getting started.

Beat stress, be happy!

Troubling Facts About Heart Disease In India

  • 52% of Cardiovascular Disease (CVD) deaths in India occur before the age of 70.
  • The years of life lost attributable to CVD in India increased by 59% from 1990 to 2010 (23.2 million to 37 million).
  • With the current burden of CVD, India would lose $237 BILLION from lost productivity and spending on healthcare over a 10 year period.
  • The prevalence of ischemic heart disease in 1960 urban India was 2%. It increased SEVEN TIMES to 14% by 2013. Even in rural India, the prevalence went up by 4 times.
  • The INTERHEART study confirmed that South Asians had a median age for heart attacks of 52 years, compared with 62 years in European people.
  • Cardiovascular risk factors increase exponentially with age once Indians reach the 30- to 39-year age group.
  • Case fatality rates for Indians following heart attacks was 17% – while in higher income countries, it was just 6.5%

About Dr. Mani:

Dr. Mani cardiologist

Dr. Mani

Heart surgeon. Author. Social entrepreneur. Fund raiser. Dr.Mani juggles many roles in pursuit of his dream – to make heart healthcare accessible to every Indian child. His non-profit has sponsored life-saving treatment for 147 ‘Heart Kids’, with many more to come. Dr.Mani’s books will inspire you to go for your dreams – and make them come true. And a share of profits go to fund a child’s operation. His latest books are ‘Knife At A Gunfight: How To Transform Your Life In 5 Easy Ways‘, and ‘Heart, Guts & Steel: The Making of an Indian Surgeon‘. Buy a book, save a life!

dr. mani cardiologist

47 Hearts: Dr. Mani’s initiative on cardiovascular health for children

You can connect with Dr.Mani on Twitter (@drmani), Facebook, LinkedIn, Instagram and Pinterest


  1. The Registrar General of India – https://www.sciencedirect.com/science/article/pii/S2214999616300297
  2. Cardiovascular Diseases in India: Current Epidemiology and Future Directions – Circulation: 2016;133:1605–1620 https://www.ahajournals.org/doi/abs/10.1161/circulationaha.114.008729
  3. ICMR-INDIAB study https://www.ncbi.nlm.nih.gov/pubmed/25101698
  4. American Heart Association https://www.everydayhealth.com/heart-health/step-up-to-heart-attack-and-stroke-prevention-3481.aspx

About Author

World’s Top Corporate Organizations including 30+ of the NIFTY-50 companies in India trust Akash as their Keynote Motivational Speaker. India’s premier colleges like IIMs, IITs, SRCC too go to him whenever they need a refreshing, big bang impact. Write to us to know how he can transform your Team.

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