The forties mark a turning point for the heart. Cholesterol builds up in the arteries, blood pressure drifts upward and blood sugar creeps higher, usually without a single symptom. Indians also tend to develop heart disease earlier than many other populations. For that reason heart health tests after 40 are best done while a person feels perfectly well, since a first heart attack is sometimes the first sign of disease. Desk-bound work, irregular meals and poor sleep add to the risk in these busy years.