Cardiovascular Risk Assessment and Its Determinants Among Older Adults in India: Evidence From a Nationally...

Cardiovascular disease (CVD) is the leading cause of mortality, posing a major challenge to its rapidly aging demographic. Early identification of individuals at high risk for future cardiovascular events is paramount for implementing timely preventative strategies. However, comprehensive population-level estimates using validated assessment tools remain limited in this setting. This study was to ascertain the prevalence and determinants of persons at high risk of experiencing any cardiovascular event within the next 10 years among older adults in India.

We analyzed data from the Longitudinal Aging Study in India Wave-1 (2017-2018), including 64,266 participants aged 40-74 years. We used the World Health Organization CVD Risk Chart 2019 version, a nonlaboratory-based risk assessment model, to stratify cardiovascular risk based on age, sex, smoking status, systolic blood pressure, and body mass index.

Weighted prevalence of high CVD risk ( ≥ 20%) was 2.67% (95% confidence interval [CI]: 2.44, 2.91), while intermediate risk (10% to < 20%) was 28.41% (95% CI: 27.60, 29.25). Overall, 31.08% had ≥ 10% risk. In the diabetes and hypertension (HTN) subgroups, high risk ( ≥ 20%) was 3.53% and 4.36%, respectively. Adjusted analysis showed significantly higher odds of high risk among alcohol users, individuals with prior HTN, and widowed/separated participants. Conversely, college education and current employment were associated with significantly lower odds.

Over 3 in 100 Indian adults aged ≥ 40 years with diabetes or HTN face a ≥ 20% 10-year CVD risk, highlighting an urgent need for targeted primary care interventions. Prioritizing alcohol cessation, aggressive blood pressure management, and glycemic control through universal standard care coverage is essential to mitigate this burden.