Heart Attacks in India: Are We at Higher Risk?


The prevalence of heart attacks in India is alarmingly high. Living in India, it's highly probable that someone within your social network experienced a heart attack last year.

But what's the underlying cause behind this widespread occurrence? Are Indians inherently more susceptible to heart attacks?

In this article, we dive into these questions and explore strategies to prevent heart disease.

Are Indians more likely to have heart attacks?

Yes. There is a predisposition to heart attacks among Indians. This is why India has double the rate of heart disease compared to Western countries.

India has a lot of heart attacks. This is because of genes causing body imbalances, weak heart muscles, and things like bad food, stress, and not moving enough. These factors are the causes of heart attacks in young age in India.

Heart attack in India statistics:

Image credit: Cardiovascular Diseases (CVDs) Detection using Machine Learning Algorithms - Scientific Figure on ResearchGate.

Even though Indians comprise only 20% of the world's population, we account for 60% of the world's heart disease burden. Hyderabad, Telangana, is the diabetic capital of the world.

Indian men are more prone to developing coronary heart disease at a younger age, often before 40. According to a study, the heart attack age in India is lower (53.0) than in other countries (58.6 years).

Cardiovascular disease and heart attack death rate in India stands at 272 per 100,000 individuals, surpassing the global average of 235 per 100,000.

Let's now discuss in detail the reason for sudden heart attacks in India.

Why heart attacks are increasing in India

A study discovered 9 modifiable factors contributing to a higher prevalence of heart attacks in the South Asian population. These factors include-

  1. Current or former smoking habit.
  2. History of Hypertension.
  3. History of Diabetes Mellitus.
  4. High Wasit-to-Hip Ratio. (WHR)
  5. Elevated ApoB100/ApoA-I ratio. (This ratio shows how much of the particles that make arteries harden are in your body compared to the particles that stop them from hardening. This ratio is considered a predictor of cardiovascular risks)
  6. Adverse psychological factors (stress or depression)
  7. Daily intake of fruits and vegetables
  8. Physical activity
  9. Moderate Alcohol consumption

The first six factors are harmful risk factors that raise the chances of having a sudden heart attack. On the other hand, the last 3 factors are protective.

In India, the prevalence of these protective factors is markedly lower, and that of the harmful risk factors is higher. So, let's understand these risk factors through different aspects.

1. Population-specific risk

Compared to people in other countries, Indians have a significantly higher waist-to-hip ratio, ApoB100/ApoA-I ratio, and current and former smoking habits.

2. Risk factors according to age

In people younger than 60, there is a higher prevalence of 3 harmful risk factors, i.e., ApoB100/ApoA-I ratio, diabetes, and WHR. At the same time, the presence of protective risk factors like consumption of fruits and vegetables, physical activity, and moderate alcohol use is lower.

3. heart attack ratio male vs female in india

In India, there are significant differences in the heterogeneity of both sexes.

Among women, the prevalent risk factors are high WHR, lack of exercise, lack of daily intake of fruits and vegetables, psychological factors, and history of diabetes.

In males, high current or past smoking rates and a high ApoB100/ApoA-I ratio are prevalent factors.

Non-modifiable risk factors

Now, let's also look into some risk factors in the Indian population that are not modifiable.

1. Size of cholesterol molecules

Even though Indians have similar low-density lipoprotein (LDL) cholesterol levels comparable to other populations, the size of LDL cholesterol particles is smaller. As a result of their smaller size, these particles are more susceptible to oxidation and can lead to arterial hardening.

High-density lipoprotein (HDL) cholesterol levels and particle size also increase the susceptibility of the South Asian population. Indians have lower HDL cholesterol levels and higher concentrations of smaller-sized, less protective HDL particles.

2. Higher risk at same BMI

Compared to the European population, Indians have higher abdominal visceral fat and increased insulin resistance at a similar Body Mass Index (BMI). Therefore, insulin resistance in Indians is frequent, even in BMIs that are traditionally considered ideal.

3. Inflammatory biomarkers

Indians have some genetic biomarkers that make them more susceptible to developing coronary heart disease and heart attacks at early ages.

Now that you understand the reason behind high heart attack rates in India. Now, let's discuss what you can do as an Indian to prevent a heart attack.

How to prevent heart attacks?

Though Indians have a higher chance of getting heart attacks, it doesn't mean that we cannot do anything about it. You can take action to improve your modifiable risk factors. Here are some tips to help you prevent a heart attack.

1. Find out if you are at risk

Suppose you are above the age of 40. In that case, you should check if you risk developing a heart attack in the next 10 years using an online test like the Framingham Risk Score calculator.

Knowing that you are at risk can help you and your doctor to create the best preventive plan and avoid a heart attack.

2. Keep track of your weight

Preserving a healthy weight is the finest thing you can do. However, if you are overweight or obese, you should try to lose weight.

3. Eat healthily

Your diet must contain fruits, whole grains, vegetables, nuts, plant-based protein, legumes, fish, and lean animal protein. It would help if you also avoid or limit unhealthy food such as refined carbohydrates, processed meats, and sweetened drinks.

Also read: Exploring the Best Foods to Improve Your Heart Health

4. Say no to tobacco

When it comes to your heart health, there is no good or safe tobacco product. Hence, you should quit using any tobacco. Also, you can discuss proven stopping strategies with your doctor if you find it challenging.

It is perfect if you don't smoke! Don't even think of starting. Also, avoid secondhand smoke.

5. Be active

If you are inactive, it's time to start now!

Perform at least 150 mins of moderate-intensity aerobic activity or 75 mins of robust activity weekly. And if you are already physically active, you can still increase your exercise for added benefits.

Also read: 3 Powerful Exercises for Healthy Heart in 2024


Knowing that you're more likely to have a heart attack, it's important to start the lifestyle changes.

Even though Indians are more susceptible to heart attacks, it doesn't mean we cannot do anything about it. On the contrary, by managing the modifiable risk factors, we can lower our chances of developing heart disease.

Would you like to have personalized guidance for managing these modifiable risk factors?

Then, the Aware Health Rewards app is your ultimate companion! We provide personalized daily action steps and diet plans to help you get on the right path. You can also track your activity and vital statistics through our health log.

Download the Aware app today and avoid heart attacks in the future!

About the author: 

Lucky Mehtani
, B. Pharm, merges his healthcare expertise with a passion for writing to enhance India's heart health. Through insightful blogs, he provides well-researched information on managing Diabetes, Hypertension, and High Cholesterol, aiming to prevent heart attacks and strokes.
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