New Delhi: Widely used global heart disease risk calculators may be underestimating the risk among Indians, with nearly 80 per cent of patients who later suffered a heart attack not being classified as “high-risk”, according to a new study.

The research, conducted by scientists from Govind Ballabh Pant Institute of Postgraduate Medical Education and Research, ESIC Medical College Faridabad and the Delhi Cancer Registry at All India Institute of Medical Sciences Delhi, analysed 4,975 patients with first-time heart attacks.

Researchers compared five widely used models, including the Framingham Risk Score, ACC/AHA ASCVD 2013, WHO charts, JBS-3 and PREVENT score, and found significant variation in risk classification.

While some models identified around 20 per cent of patients as high-risk, others flagged far fewer, with the ASCVD 2013 model identifying only about 12.3 per cent, placing most patients in low- or moderate-risk categories.

Experts said Indians exhibit different disease patterns, including earlier onset and higher diabetes burden, leading to underestimation of risk by Western models.

The study highlighted the need for India-specific risk assessment tools to improve early detection and prevent avoidable deaths.