Heart risks don’t always start in heart: Diabetes and kidney disease emerge as major factors fuelling attacks

NEW DELHI: Diabetes and kidney disease are emerging as major yet under-recognised drivers of heart-related complications, with experts warning that cardiovascular risks often begin far beyond the heart itself.

Health data and recent studies highlight a worrying lack of awareness about the close link between metabolic disorders and cardiovascular disease. Medical professionals say conditions such as diabetes, high blood pressure, and chronic kidney disease frequently interact, significantly increasing the likelihood of heart attacks and strokes.


According to estimates from the ICMR–India Diabetes Study, 101 million Indians (11.4%) are currently living with diabetes, while 136 million (15.3%) are classified as prediabetic. Public health experts note that every fifth person globally with diabetes or prediabetes is from India, underlining the scale of the challenge.

International data reflects similar trends. Studies cited from US health agencies indicate that a substantial proportion of adults remain unaware of underlying conditions. Nearly 1 in 4 US adults with diabetes reportedly do not know they have the disease, while 9 in 10 adults with chronic kidney disease are unaware of their condition. Additionally, around 5 in 10 US adults are estimated to have high blood pressure, and 1 in 3 has elevated total cholesterol.

Doctors emphasise that the overlap between heart disease, kidney disease, and metabolic disorders is now recognised as cardiovascular-kidney-metabolic (CKM) syndrome — a cluster of interlinked conditions that can lead to disability and premature death if left unmanaged.

Findings from a North Indian study published in April 2025 in the European Journal of Cardiovascular Medicine suggest that awareness levels remain uneven. While many participants identified diabetes (77%) and hypertension (71.5%) as key cardiovascular risk factors, fewer understood the role of LDL (“bad”) cholesterol (57%) and optimal blood pressure targets (38.5%). Only 17% of respondents demonstrated “excellent” awareness of the diabetes–heart disease connection.

Endocrinologist Dr Shashank Joshi warned that metabolic disorders lie at the root of a wide spectrum of serious illnesses.

“Metabolic syndrome and diabetes are the mother of all diseases. Nearly 80% of heart attack deaths are linked to metabolic syndrome. Excess glucose damages the inner lining of blood vessels, accelerating cardiovascular disease and stroke, while also affecting the retina and kidneys,” he said.

Health experts stress that early detection, lifestyle modification, and routine screening for blood sugar, blood pressure, kidney function, and cholesterol levels are critical to reducing long-term cardiovascular risks.

With India facing a rapidly growing burden of metabolic disease, doctors say improving public awareness may be as important as medical treatment in preventing future cardiac events.