The reasoning: epidemiology
- Ischaemic heart disease is the leading cause of death in India; stroke ranks in the top three.
- Premature onset: about half of CHD events in Indian men occur before 50 years.
- Urban > rural historically, but rural rates are rising fast.
- South Asian phenotype: central adiposity at lower BMI, insulin resistance, atherogenic dyslipidaemia (high TG, low HDL, small dense LDL), high Lp(a).