Cardiovascular risk rising in younger Indians, experts urge earlier screening

Cardiovascular disease is emerging as a major health challenge in India, with evidence showing that Indians experience heart attacks nearly a decade earlier than people in many Western countries, according to medical experts. This trend has prompted calls for more aggressive, India-specific approaches to risk assessment and management.

Several factors contribute to this increased vulnerability. South Asians have a known genetic predisposition to heart disease. When combined with abdominal obesity, sedentary lifestyles, unhealthy diets, smoking, alcohol consumption, and rising rates of diabetes, hypertension, and metabolic syndrome, the risk becomes significantly elevated. Metabolic dysfunction linked to fatty liver disease, often associated with insulin resistance, further compounds the problem.

A key factor is atherogenic dyslipidemia, a lipid abnormality common among Indians. It is marked by high triglycerides, low levels of protective HDL cholesterol, and the presence of small, dense LDL particles. Notably, traditional LDL cholesterol levels may appear normal even as cardiovascular risk silently increases.

In response, the Lipid Association of India (LAI) released updated consensus guidelines in 2023 recommending more aggressive LDL cholesterol targets for Indian patients. The guidelines advise that individuals at high cardiovascular risk aim for LDL levels below 70 mg/dL, those at very high risk target below 50 mg/dL, and patients at extreme risk—such as those with recurrent events—strive for levels below 30 mg/dL. The LAI has been recommending aggressive LDL lowering since 2016.

The guidelines also stress early detection. They recommend that young adults undergo an extended lipid profile, including Apolipoprotein B (Apo B) and Lipoprotein(a) tests, as early as their college years. ApoB reflects the total number of harmful lipoprotein particles in the blood. This proactive approach aims to identify risk before it leads to serious cardiac events.

Cardiovascular disease prevention experts emphasize that lifestyle modifications—including a balanced diet, regular physical activity, and avoidance of tobacco—remain foundational. However, for those with elevated risk, early pharmacological intervention may be necessary. Regular monitoring and adherence to treatment protocols are crucial.

The views expressed in this article are based on medical expert opinions and should not replace professional medical advice. Individuals are advised to consult their healthcare provider for personalized guidance.