No cholesterol, no diabetes, other test reports normal: 5,000 heart attack cases in India reveal surprising findings in 'healthy' Indians

A groundbreaking study on 5,000 heart attack patients reveals a striking reality: in India, heart attacks occur roughly a decade earlier than in Western populations, and they often strike with greater severity. Dr Mohit Gupta, Professor of Cardiology at GB Pant Hospital, in an interview with ANI shared that commonly used Western risk scores fail to accurately predict heart attack risk in Indian patients. Many are classified as low or moderate risk despite underlying health dangers, highlighting the urgent need for region-specific evaluation and prevention strategies.

Dr Gupta emphasises that lifestyle advice alone—avoiding stress and indulging freely in food—is no longer sufficient. Traditional risk scores overlook critical factors unique to the Indian population, including genetic predispositions, environmental pollution, and subtle metabolic differences. Even individuals without obesity may face a high risk of heart attack due to low lipid thresholds and other invisible markers. He added that stress was ranked the third attributor to heart disease after smoking and diabetes, in a study published 20 years earlier.

What did the expert find?

Dr. Mohit Gupta highlights the limitations of using Western risk calculators for predicting heart attacks in India. Even patients without traditional risk factors—no diabetes, smoking, or abnormal lipid levels—can experience cardiac events, revealing hidden risk factors unique to the Indian population. He stresses that a “low-risk” label from foreign calculators does not guarantee safety, emphasizing the need for careful lifestyle modifications and vigilant monitoring. Gupta’s study, soon to be published in the Journal of American College of Cardiology, Asia version, is a landmark effort demonstrating that these calculators are not fully valid for India and long-term, population-specific research is essential.

Historically, stress ranked as a top contributor to heart disease, but modern assessments have largely ignored its role. Dr Gupta underscores that today’s fast-paced, performance-driven lifestyles, combined with environmental and hereditary factors, demand recalibrated risk evaluations. Indians may appear healthy on the surface, yet low to moderate lipid levels and average body parameters are enough to trigger cardiac events, stressing the need for lower thresholds and proactive monitoring.

Indians are prone to high levels of lipoprotein

In an interview with TOI, Dr. Kaushal Chhatrapati, Senior Interventional Cardiologist and author of Heartstrong, highlighted the rising prevalence of heart attacks in individuals under 40, attributing it to a mix of genetics, lifestyle, and environmental factors.




He pointed out that Indians are particularly prone due to high levels of Lipoprotein(a), small dense LDL cholesterol, and elevated homocysteine, all of which increase the risk of artery blockages and blood clots. A high-carbohydrate diet further compounds the problem, while air pollution acts as a silent accelerator—living in heavily polluted cities like Delhi can be equivalent to smoking 20-50 cigarettes daily, dramatically stressing the cardiovascular system.