Why Indians Have High Bad Cholesterol and Face Greater Heart Attack Risk, Cardiologist Explains

Heart disease has emerged as one of the most serious public health challenges in India, with cardiologists warning that Indians face heart attacks at a much younger age compared to Western populations. A key contributor to this growing crisis is elevated levels of low-density lipoprotein (LDL), commonly known as bad cholesterol.

Medical experts say Indians not only develop high LDL cholesterol more frequently, but they also experience heart damage at lower cholesterol thresholds. In practical terms, cholesterol levels that may be considered borderline or moderate in Western countries can significantly increase heart attack risk among Indians.

Why Indians Are More Vulnerable to High LDL Cholesterol

Cardiologists point to genetics as a major underlying factor. Indians tend to have a different body composition, including higher visceral fat — fat stored around internal organs — even at lower body mass index (BMI) levels. This fat distribution negatively affects how the body processes fats and sugars, leading to higher LDL levels and faster plaque formation in arteries.

Additionally, Indians are more prone to insulin resistance, a condition that worsens cholesterol imbalance and accelerates artery blockage. Because of these inherited metabolic traits, many Indians develop coronary artery disease nearly a decade earlier than people in Western countries.

This genetic predisposition means that even young adults in their 30s and 40s may already have significant arterial damage, often without knowing it.

Lifestyle Habits That Worsen Cholesterol Levels

While genetics load the gun, lifestyle often pulls the trigger.

Modern dietary patterns in India have shifted sharply over the past two decades. Increased consumption of processed foods, refined carbohydrates, deep-fried snacks, sugary beverages and high saturated fat meals has contributed to rising LDL cholesterol levels.

At the same time, physical activity has declined. Desk-bound jobs, long commuting hours and limited exercise have become common, particularly in urban areas. Lack of regular movement not only raises bad cholesterol but also lowers high-density lipoprotein (HDL), or good cholesterol, which helps remove excess fat from blood vessels.

Chronic stress, irregular sleep patterns and rising obesity further compound the problem. Together, these factors create a dangerous imbalance where bad cholesterol builds up while protective cholesterol declines, significantly raising heart attack risk.

Why High Cholesterol Often Goes Undetected

One of the biggest dangers of high cholesterol is that it is largely silent. Most people experience no symptoms until a major cardiac event occurs.

Blocked arteries can develop slowly over years without causing noticeable discomfort. By the time symptoms such as chest pain, breathlessness or sudden fatigue appear, the damage may already be severe.

This is why cardiologists stress the importance of preventive screening. Adults over 30, especially those with a family history of heart disease, diabetes, high blood pressure or obesity, should undergo regular lipid profile testing even if they feel healthy.

How Indians Can Lower Bad Cholesterol and Protect the Heart

Experts emphasise that lifestyle changes can dramatically reduce heart risk, even for those with genetic vulnerability.

A heart-friendly diet rich in fruits, vegetables, whole grains, nuts, seeds and lean proteins helps lower LDL levels. Reducing intake of processed foods, trans fats and excess sugar is equally important.

Daily physical activity plays a powerful role. Even moderate exercise such as brisk walking for 30 minutes a day can improve cholesterol balance, strengthen the heart and reduce inflammation.

Managing stress, maintaining a healthy weight and quitting smoking further enhance heart protection. In some cases, doctors may also recommend cholesterol-lowering medications for individuals at high risk.

Cardiologists agree on one thing: early action saves lives. Understanding why Indians are more vulnerable to bad cholesterol is the first step toward reversing the trend of early heart attacks and building a healthier future.