## Major CVD Risk Factors in India **Key Point:** Hypertension is the single most important modifiable risk factor for CVD in India, accounting for the largest population attributable fraction (PAF) of approximately 25–30% of CVD burden. **High-Yield:** The India State-Level Disease Burden Initiative (ILDB) and the Prospective Urban Rural Epidemiology (PURE) study demonstrate that hypertension is responsible for more CVD deaths and disability than any other single risk factor in the Indian population. The prevalence of hypertension in India ranges from 20–40% depending on urban/rural setting and age group. **Mnemonic:** ABCDE of CVD risk in India — **A**lcohol (rising), **B**lood pressure (hypertension — #1), **C**holesterol (dyslipidemia), **D**iabetes, **E**xcessive weight. Hypertension is the "B" and the most impactful. **Clinical Pearl:** Unlike Western populations where smoking historically had a higher PAF, in India hypertension has emerged as the dominant risk factor due to rapid urbanization, dietary sodium intake, stress, and poor awareness/control rates (only ~10% of hypertensives have optimal BP control). ## Comparative Population Attributable Fraction (PAF) in India | Risk Factor | PAF (%) | Prevalence (%) | | --- | --- | --- | | Hypertension | 25–30 | 20–40 | | Dyslipidemia | 12–15 | 25–35 | | Smoking | 10–12 | 10–15 | | Obesity (BMI >30) | 8–10 | 5–15 | | Diabetes | 8–10 | 8–12 | [cite:Park 26e Ch 8] 
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