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The Lancet Diabetes & Endocrinology, 2023

Dyslipidaemia in India: 81.2% of adults, and most were never told

The ICMR-INDIAB study found dyslipidaemia — an abnormality in blood lipids — in 81.2% of the Indian adults it sampled. It is the single most prevalent finding in the largest metabolic survey ever conducted in India, and the great majority of those affected had never been informed. Dyslipidaemia is not a disease in itself but a risk state, and its consequences are cardiovascular: India records 28.1% of all deaths as cardiovascular, up from 15.2% in 1990, with 53.4% of those deaths occurring before the age of 70. High cholesterol alone accounts for an estimated 29.4% of the national cardiovascular burden. The gap between how common the abnormality is and how rarely it is communicated is the practical finding here, and it is one a blood test resolves.

01

What does 81.2% actually mean?

Dyslipidaemia covers any abnormality in the lipid panel: raised LDL cholesterol, raised triglycerides, low HDL, or a combination. ICMR-INDIAB found at least one such abnormality in 81.2% of the adults it sampled.

A prevalence that high changes what a "normal" report signifies. When four in five adults have an abnormality, the reference ranges built from that population describe what is common rather than what is healthy — and a result inside them is weaker reassurance than it appears.

02

Why does this matter more in India than elsewhere?

Because the outcome arrives earlier. GBD India data published in The Lancet Global Health found that 53.4% of Indian cardiovascular deaths occur before the age of 70, against a much lower proportion in high-income countries. Cardiovascular disease in India is substantially a disease of working age.

The same analysis attributes 29.4% of India's cardiovascular burden to high cholesterol alone — the single largest identified contributor, and one of the most modifiable.

03

Does a standard lipid panel capture the risk?

Incompletely. A standard panel reports total cholesterol, LDL, HDL and triglycerides, all of which measure the amount of cholesterol carried rather than the number of particles carrying it. ApoB counts those particles directly, and Lp(a) captures an inherited component that is more common in South Asian populations and appears on no routine panel.

The practical consequence is that a person can hold a normal-looking lipid report while carrying a high particle count and an elevated inherited risk, neither of which was measured.

04

The data

Share of all deaths in India that are cardiovascularBar chart showing cardiovascular deaths as a share of all deaths in India: 15.2% in 1990 rising to 28.1% in 2016.199015.2%201628.1%
Share of all deaths in India that are cardiovascular · % of all deaths
05

Key figures

  • 81.2% of Indian adults sampled had dyslipidaemia (ICMR-INDIAB, 2023).
  • 28.1% of all deaths in India are cardiovascular, against 15.2% in 1990 (GBD India, 2018).
  • 53.4% of Indian cardiovascular deaths occur before age 70.
  • High cholesterol alone accounts for 29.4% of India's cardiovascular burden.
06

Common questions

If 81% of adults have it, is it still abnormal?

Yes. Prevalence and normality are different things. A finding can be common and still carry risk, and reference ranges derived from a population in which most people have the abnormality will describe the abnormality as unremarkable. That is precisely the trap here.

Which lipid marker matters most?

ApoB is the most informative single measure of atherogenic risk, because it counts the particles capable of lodging in an artery wall rather than weighing the cholesterol inside them. Lp(a) is worth measuring once, since it is inherited, more common in South Asians and invisible on standard panels.

07

Sources

  1. 01Anjana RM et al., ICMR-INDIAB national cross-sectional study. The Lancet Diabetes & Endocrinology, 2023.
  2. 02ICMR-INDIAB national study, The Lancet Diabetes & Endocrinology, 2023
  3. 03GBD India cardiovascular study, The Lancet Global Health, 2018
08

More Indian population health data

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Authorship & review

Written by the Peak Brain clinical team. Assigned clinical reviewer: Dr. Nitesh Arora, MD, DM — review pending; this page has not yet been signed off.

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This page is general health information, not medical advice, diagnosis or treatment. Reference ranges vary between laboratories. Never delay or disregard advice from a qualified health professional because of something you read here. If you think you may have a medical emergency, call your local emergency number.