India accounts for 20% of heart attack deaths worldwide, finds report

New report highlights how prevention gaps, delayed treatment and rising lifestyle risks are driving India's growing share of the global cardiac crisis

India is facing a silent yet rapidly escalating cardiac emergency, and the warning signs are becoming impossible to ignore. According to the Beat by Beat 2025 report by BM Birla Heart Hospital, India alone accounts for nearly 20 per cent of all heart attack deaths among more than 190 nations, placing it at the centre of a growing global crisis. While cardiovascular disease was once viewed largely as a condition affecting older populations, it is now striking Indians earlier and more aggressively. The consequences are being felt across families, workplaces and the wider health system.

 

What the data reveals about India's cardiac burden

 

India’s cardiovascular burden is both large and rising.

 

• One in 20 Indians is living with cardiovascular disease
• Cardiovascular disease accounts for nearly 25 per cent of all deaths in the country, and 60 per cent of these are premature
• India’s cardiovascular death rate stands at 272 per 100,000, which is significantly higher than the global average of 235
• Half of heart attack deaths occur at home due to delays in seeking treatment

 

The report also notes that Indians develop heart disease nearly a decade earlier than the global average, meaning working-age adults are increasingly at risk. This early onset not only shortens lives but also places a heavy economic burden on families and the healthcare system.

 

Eastern India: A high-risk epicentre

 

Although heart disease affects the entire country, eastern India carries a disproportionate burden.

 

• One in 10 adults in the region is affected
• Eastern India accounts for 30 per cent of the nation’s cardiovascular deaths
• West Bengal reports a higher ischemic heart disease prevalence than the national average
• Stroke rates in eastern states exceed the national average

 

The report highlights that underdiagnosis remains a major concern in states such as Bihar and Jharkhand, where limited healthcare access and inadequate screening contribute to lower reported numbers. However, lower reporting does not mean lower risk. Experts warn that delayed detection often results in patients presenting with advanced disease.

 

Asia’s growing cardiovascular burden

 

While India stands at the centre of the crisis, the wider Asian region is also witnessing a sharp rise in cardiovascular disease, and the patterns reveal serious regional disparities.

 

• South Asia’s ischemic heart disease burden is 80 per cent higher than East Asia and 30 per cent higher than Southeast Asia
• Stroke accounts for 42 per cent of cardiovascular deaths in South Asia, which is higher than the global average
• Southeast Asia records the highest rates of haemorrhagic stroke, largely linked to uncontrolled hypertension
• Rheumatic heart disease in South Asia is four times higher than in East Asia and seven times higher than in Southeast Asia
• Cardiovascular deaths across Asia surged during the pandemic years, and structural risk factors continue to sustain high mortality

 

Why are heart attacks rising?

 

The rise in heart attacks across India is not driven by a single cause, but by a web of metabolic, behavioural, environmental and systemic factors that reinforce one another.

 

1. Metabolic risks   Metabolic factors account for 56.5 per cent of the increased risk of cardiovascular deaths, and they remain the single largest contributor.

• High systolic blood pressure contributes 54 per cent
• Elevated LDL cholesterol accounts for 19 per cent
• Rising blood sugar levels and kidney dysfunction contribute 11 per cent
• Increasing obesity levels add another 10 per cent

 

These conditions often develop silently, yet they significantly increase the likelihood of heart attacks and strokes if left untreated.

 

2. Lifestyle risks   Lifestyle habits are closely linked to metabolic disorders, and together they amplify cardiac risk.

• Unhealthy diets contribute 30 per cent to overall risk
• Tobacco use accounts for 7 per cent of cardiovascular deaths
• Physical inactivity contributes 7 per cent
• Alcohol use adds 5 per cent

 

3. Environmental risk factors   Globally, 7 million deaths have been linked to cardiovascular disease caused by air pollution, and environmental risk factors account for 23 per cent of total cardiovascular deaths. Prolonged exposure to polluted air increases inflammation and vascular damage, which in turn raises the risk of heart attacks and strokes.

 

4. Other emerging threats

• Social isolation is associated with a 15 per cent higher risk of coronary heart disease
• Poor sleep and circadian disruption increase inflammation and blood pressure
• Imbalance in gut microbiota can trigger inflammation and damage blood vessels, which increases the risk of heart disease

 

5. Delayed care and the 'Golden Hour' gap

 

Half of heart attack deaths occur at home due to delayed treatment. In South Asia, stroke deaths are frequently linked to missed “golden hour” opportunities, which refer to the first 60 minutes after symptoms begin. Limited access to advanced Cath Labs and emergency cardiac services further reduces survival chances, especially in smaller cities and rural regions.

 

How innovation is reshaping patient care

 

Preventive technologies such as AI-based risk prediction tools, wearable sensors and Bluetooth-enabled continuous glucose monitoring allow early detection of cardiovascular risk. These tools can flag abnormalities before symptoms appear, and they empower patients to take proactive action.

 

On the curative front, minimally invasive procedures such as Transcatheter Aortic Valve Implantation (TAVI) and robotic-assisted surgeries are reducing recovery time and surgical risk. Advanced Cath Labs equipped with AI-enhanced imaging are improving procedural precision and outcomes.

 

Experts stress that technology must be scaled beyond metro cities so that Tier- 2 and 3 regions can benefit equally.

 

What needs to change

 

Experts behind the report recommend a multi-layered response.

 

• Strengthen early screening programmes, especially in rural and underserved regions
• Improve emergency response systems to reduce golden hour delays
• Expand healthcare infrastructure in eastern and smaller cities
• Promote lifestyle interventions focusing on diet, exercise and stress management
• Integrate digital health tools into routine preventive care

They also emphasise the need for stronger public awareness campaigns, because recognising symptoms early and seeking immediate medical attention can save lives.     

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This report is for informational purposes only and is not a substitute for professional medical advice.