India’s diabetes burden is well known, but what’s less visible is the cardiac or heart risk that rides silently alongside it. With cardiovascular disease (heart disease) being the leading cause of death among people with Type 2 diabetes1, understanding and acting on India’s unique cardiac risk profile is no longer optional, but urgent.
What Is India’s heart risk score in diabetes?
Two major tools are helping clinicians assess heart risk in Indian diabetics: 1. Indian Diabetes Risk Score (IDRS)2 Developed through the Chennai Urban Rural Epidemiology Study (CURES), IDRS uses four simple factors: age, waist size, family history, and physical activity to predict diabetes and associated heart risks.
An IDRS score above 60 indicates high risk for both diabetes and cardiovascular disease
In Chennai, average IDRS scores rose from 48 in healthy individuals to 61 in diabetics, showing a clear link between metabolic and cardiac risk
Even among people without diabetes, a high IDRS correlates with elevated cholesterol, triglycerides, and blood pressure, all major heart risk factors.
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Dr. Anand Kumar. VMD. DM. FESC. FACC, Senior Consultant and Interventional Cardiologist, Lakeshore Hospital, Cochin, Kerala, India
2. QRISK3 Score3 This UK-developed tool has been adapted for Indian populations and is now recommended by the Lipid Association of India (LAI). It calculates a person’s 10-year risk of heart attack or stroke, factoring in ethnicity, diabetes status, cholesterol levels, blood pressure, and lifestyle habits.
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The average QRISK3 score for Indian people with diabetes was 15.3%, with men showing significantly higher risk than women3
Regional insights: Chennai and Kochi Chennai As the birthplace of IDRS2, Chennai has led the way in linking diabetes to heart risk. Urban lifestyle factors — processed food, sedentary jobs, and high stress — have pushed IDRS scores higher, even among younger adults. The city’s data has helped shape national screening strategies.
Kochi In Kerala, where healthcare access is relatively strong, studies from Kochi show that even normoglycemic individuals (those without diabetes) with high IDRS scores have elevated lipid levels and blood pressure . This suggests that heart risk starts before diabetes does, making early screening essential.
Why Indians must be extra vigilant about heart/cardiac risk in diabetes
Earlier onset of heart disease4 Indians tend to develop both diabetes and heart disease at least a decade earlier than Western populations. This means complications can begin in the 30s or 40s, often while people are still in the prime of their careers, making early screening and management critical.
Unique lipid profile5 Many Indians have a unique cholesterol pattern — low levels of good cholesterol (HDL) and high levels of triglycerides, even when their overall cholesterol looks normal. This combination quietly increases the chances of heart attacks and strokes, especially in people with Type 2 diabetes.
High prevalence of central obesity6 Indians often carry excess fat around the abdomen, even at a normal BMI. This central obesity is strongly linked to insulin resistance and cardiovascular risk. Tools like the QRISK3 Score or IDRS factor this in, making them more accurate for Indian populations than global models.
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A World Heart Month wake-up call As we mark World Heart Month and approach World Heart Day on September 29, it’s time to recognise that diabetes and heart disease are not separate battles — they’re deeply connected. Tools like IDRS and QRISK3, backed by data from cities like Chennai and Kochi, are helping India fight smarter. Every Indian needs to be more heart-aware, especially during World Heart Month. Knowing your risk score, staying active, eating smart, and talking to your doctor regularly can make a huge difference not just for your heart, but for your overall health.
Your next check-up could be your most important one. Ask your doctor about your heart risk score. Because in India, your heart and your sugar levels are speaking the same language — and it’s time we listened.
References:
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Ma CX, Ma XN, Guan CH, Li YD, Mauricio D, Fu SB. Cardiovascular disease in type 2 diabetes mellitus: progress toward personalized management. Cardiovasc Diabetol. 2022 May 14;21(1):74. doi: 10.1186/s12933-022-01516-6. PMID: 35568946; PMCID: PMC9107726.
Mohan V, Gokulakrishnan K, Ganesan A, Kumar SB. Association of Indian Diabetes Risk Score with arterial stiffness in Asian Indian nondiabetic subjects: the Chennai Urban Rural Epidemiology Study (CURES-84). J Diabetes Sci Technol. 2010 Mar 1;4(2):337-43. doi: 10.1177/193229681000400214. PMID: 20307394; PMCID: PMC2864169.
Joshi P., Islam S., Pais P., et al. Risk factors for early myocardial infarction in South Asians compared with individuals in other countries. JAMA. 2007;297:286–294. doi: 10.1001/jama.297.3.286
Sawhney JPS, Gupta R. Indian dyslipidaemia guidelines: Need of the hour. Indian Heart J. 2024 Mar;76 Suppl 1(Suppl 1):S2-S5. doi: 10.1016/j.ihj.2024.01.008. Epub 2024 Jan 12. PMID: 38219904; PMCID: PMC11019334.
Prasad DS, Kabir Z, Dash AK, Das BC. Abdominal obesity, an independent cardiovascular risk factor in Indian subcontinent: A clinico epidemiological evidence summary. J Cardiovasc Dis Res. 2011 Oct;2(4):199-205. doi: 10.4103/0975-3583.89803. PMID: 22135477; PMCID: PMC3224439.
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