Data show early cardiovascular risk driving health insurance premiums

Young adults in India are facing an often-overlooked financial burden from heart disease, even before symptoms appear, according to a new analysis by Plum Insurance.

The study, which reviewed over 9,500 cardiac claims and 10,000 health check-ups, finds that silent cardiovascular risk in people in their late 20s and early 30s is already impacting insurance premiums and eligibility. The data highlights that heart disease, traditionally seen as a condition of older age, is emerging as a costly concern for younger Indians.

Key findings:

• One in three cardiac claims costs more than double the median value.


• Severe episodes, often requiring ICU care or surgery, can exceed ₹5 lakh.


• Nearly 60% of heart-related claims involve surgical intervention.


• Heart disease consistently accounts for 46% of chronic non-communicable disease patients, nearly double the next largest category, cancer (24%).


• Cardiovascular conditions are affecting people in their 30s, with early risk factors detectable in routine health check-ups among 20-somethings.

The analysis also highlights the financial severity of heart disease.

Critical hospitalisations can wipe out over a decade of household savings, with extreme cases costing ₹25–28 lakh. Even mild episodes average ₹38,000, representing months of typical household savings.

Underlying risk factors

Plum’s study examined cardiovascular biomarkers, revealing that standard cholesterol tests often underestimate risk. More than 60% of Indians showed high risk when measured by the ApoB/ApoA1 ratio—a strong predictor of heart attack—compared to only 23% using conventional atherogenic measures.

Risk patterns differ by age and gender:

• More than half of 21–30-year-olds already have unfavorable ApoB/ApoA1 ratios.


• By the 30s, nearly two-thirds of young adults show elevated atherogenic burden.

Men are more prone to high atherogenic cholesterol, while women face greater challenges with protective HDL levels and inflammation markers.

Plum Insurance emphasises a significant “prevention window”: risk factors appear decades before hospitalization, providing an opportunity for early intervention. Lipid and inflammation risks emerge by the early 20s, while metabolic risks typically surface in the 40s, converging with clinical events around age 59.

The findings stress that cardiovascular disease is not just a late-life concern but a growing financial and health challenge for young Indians,  a “hidden heart tax” that silently accumulates long before a hospital visit.

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