World Heart Day 2026: Is your heart working overtime? Mumbai docs tell you more 

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From the way we spend our workdays to what we eat, how we sleep and how we unwind, several everyday choices can have a bearing on our heart health. While heart disease is often associated with major lifestyle changes or obvious warning signs, some of the factors that influence cardiovascular health are in our daily habits that may often be taken for granted and ignored. 

With busy schedules, long working hours, sedentary routines and changing dietary habits becoming part of our lives, it is important to look at how these patterns may affect the heart over time. But which habits deserve attention, and when does every day behaviour begin to become a cardiovascular concern? 

As people observe World Heart Day on September 29 every year to raise awareness about the importance of heart health, there is more to a healthy heart than most people know. Dr. Rushikesh Patil, associate director of Cardiac Heart Centre, LH Hiranandani Hospital, and Dr Rithin Ratnakar, additional director – Aortic Diseases, Sir H. N. Reliance Foundation Hospital, highlight how everyday lifestyle patterns can affect the heart, which habits people often overlook, and what changes can help protect cardiovascular health in the long run.

The doctors also explain what people mean when they describe the heart as ‘working overtime’, and whether seemingly small lifestyle choices can have a cumulative effect on the cardiovascular system.

What does it mean when we say that the heart is ‘working overtime’? Is the heart actually working harder with every heartbeat?

Dr Patil: The heart beats continuously and adjusts to the body’s needs. When blood pressure remains elevated, the heart has to generate more force with every beat to push blood through the arteries. Over the years, this can cause thickening of the heart muscle and eventually affect its ability to relax or pump effectively. So, ‘working overtime’ does not mean that the heart is literally running out of beats, but that it is repeatedly being asked to pump against greater pressure or meet greater physiological demands.

Dr Ratnakar: Your heart beats about 1 lakh times a day and is an epitome of efficiency. There are things we do in favour of its efficiency and things that are being done against it. The relationship between these factors is not always linear, as most of us think. When it comes to prevention of non-communicable diseases, there are usually two sets of factors – modifiable and non-modifiable. Factors such as age, sex and genetics cannot be modified, but it is largely the controllable or modifiable factors that contribute to heart disease, mostly coronary artery disease.

Can chronic stress make the heart work harder?

Dr Patil: When you are stressed, the body releases cortisol and adrenaline, which can raise the heart rate and blood pressure. An occasional stressful moment is normal, but constant low-grade stress from work pressure, doom-scrolling or unresolved anxiety can keep the cardiovascular system in a persistent state of alert. Over time, this can contribute to inflammation and higher cardiac events.

Dr Ratnakar: Stress, along with prolonged sitting and lack of exercise, can contribute to an increasing waistline and directly correlate with cardiovascular morbidity and mortality. Sleep and lack of sleep can also increase stress levels, adding to the overall cardiovascular burden.

How does high blood pressure increase the workload on the heart?

Dr Patil: When blood pressure remains elevated, the heart has to generate more force with every beat to push blood through the arteries. Over years, this increased workload can cause thickening of the heart muscle and eventually impair its ability to relax or pump effectively. Excess salt can also promote fluid retention and hypertension, increasing the pressure against which the heart has to pump.

Dr Ratnakar: Consuming ultra-processed foods and having a high sodium intake can directly increase blood pressure and stiffness of the arteries. This makes the heart work harder to push the same amount of blood with every beat, slowly causing an increase in the thickness of the heart wall and eventually contributing to heart failure.

Can sitting for long hours and lack of exercise affect the heart even if a person does not feel any symptoms?

Dr Patil: Physical inactivity reduces cardiovascular efficiency. Prolonged inactivity can also contribute to excess body weight, which makes the heart work harder because a larger body requires more blood flow. Obesity can also raise blood pressure, promote sleep apnoea and cause metabolic inflammation. Over time, this increased workload can contribute to heart enlargement, dysfunction and heart failure.

Dr Ratnakar: Sitting for prolonged periods, lack of exercise and stress usually contribute to an increasing waistline and directly correlate with cardiovascular morbidity and mortality. These are important modifiable factors when it comes to cardiovascular health.

Can poor sleep put additional stress on the heart?

Dr Patil: Regularly sleeping for less than six hours, or having untreated sleep apnoea, is strongly associated with hypertension and heart strain. Sleep apnoea causes repeated pauses in breathing, resulting in intermittent oxygen drops, surges in sympathetic activity and blood-pressure fluctuations, all of which increase cardiac stress. Loud snoring, witnessed episodes of apnoea and daytime sleepiness warrant evaluation and a sleep study.

Dr Ratnakar: Sleep and lack of sleep directly increase stress levels, while sleep disorders associated with obesity, such as obstructive sleep apnoea, can directly affect the heart and cause it to fail in the long run.

Can excess body weight make the heart work harder?

Dr Patil: Excess body weight makes the heart work harder in several ways. A larger body requires more blood flow, which increases cardiac output and blood volume. Obesity can also raise blood pressure, promote sleep apnoea and cause metabolic inflammation. This means the heart has to pump against greater resistance while also meeting higher oxygen demands. Over time, this increased workload may contribute to heart enlargement, dysfunction and heart failure.

Dr Ratnakar: An increasing waistline, particularly when associated with prolonged sitting, lack of exercise and stress, is an important cardiovascular concern. Since excess body weight is a modifiable factor, addressing it can help reduce cardiovascular risk.

How do ultra-processed foods and excess salt affect the heart?

Dr Patil: Excess salt can promote fluid retention and hypertension, increasing the pressure against which the heart pumps. Reducing excess salt and processed foods can therefore help reduce cardiovascular stress.

Dr Ratnakar: Consuming ultra-processed foods and high amounts of sodium directly increases blood pressure and stiffness of the arteries. As the arteries become stiffer and blood pressure rises, the heart has to work harder to push the same amount of blood with every beat. Over time, this can increase the thickness of the heart wall and contribute to cardiac dysfunction.

Does smoking and vaping directly affect the heart, or is the damage mainly to the lungs?

Dr Patil: Smoking and tobacco directly increase heart rate and blood pressure and damage the blood vessels. These effects increase cardiovascular stress and can contribute to heart-related complications.

Dr Ratnakar: Smoking and vaping directly increase blood pressure and make the lining of the blood vessels stickier and more fragile. This can cause blood to clot or plaques to break off, potentially leading to heart attacks.

Can alcohol consumption also put the heart under pressure?

Dr Patil: Excessive alcohol consumption can affect the heart. Regularly exceeding moderate alcohol limits can trigger irregular heart rhythms and elevated blood pressure in susceptible people.

Dr Ratnakar: Alcohol consumption directly affects the heart too, unlike what many people believe. Alcoholic cardiomyopathy can occur with long-term alcohol intake and is an important cause of heart failure.

Can too much caffeine, energy drinks or stimulants increase cardiac demand?

Dr Patil: Occasional coffee is not necessarily the issue. The concern is daily excess, particularly multiple energy drinks or regularly consuming excessive amounts of caffeine. In susceptible people, this can trigger irregular heart rhythms and elevated blood pressure. Overtraining, dehydration and stimulant use can also temporarily increase cardiac demand.

Can emotional health and social isolation affect cardiovascular health too?

Dr Patil: Bottling up anger or sadness rather than processing emotions has been associated with elevated blood pressure and heart-rate reactivity. This does not mean constantly venting, but chronic suppression of emotions seems to take a physical toll. Research also increasingly links social isolation to higher cardiovascular risk. Staying socially connected, maintaining meaningful relationships, participating in community activities and seeking support when needed can help support emotional and cardiovascular well-being.

What can people do to reduce the burden on their heart?

Dr Patil: Much of this burden is modifiable. Regular exercise, maintaining a healthy weight, reducing excess salt and processed foods, avoiding tobacco, sleeping adequately and controlling blood pressure, cholesterol and diabetes can all help reduce cardiovascular stress.

Dr Ratnakar: Prevention is important because many of the factors contributing to cardiovascular disease are modifiable. Your heart works tirelessly for you even before you’re born. The least you can do for it is to help it do its job.