New Delhi. September 2025.

Cardiovascular disease (CVD) claims nearly 18 million lives worldwide each year, with India accounting for roughly one-fifth of these deaths¹— more than all cancers combined — yet one of its critical genetic risk factors remains largely invisible.^2,3 It is estimated that approximately 25% of the Indian population has elevated lipoprotein(a), or Lp(a), but is rarely tested and often overlooked in heart health strategies.⁵

Ahead of World Heart Day (29 September), Global Heart Hub and Novartis convened international healthcare experts for the educational media webinar “Introducing the Little (a) with Big Consequences,” to spotlight elevated Lp(a) as a critical, underrecognized inherited condition that independently increases risk of cardiovascular disease such as heart attack or stroke.^6,7

In the Asia Pacific and Middle East region, two in three individuals (66%) skip routine heart tests, while nearly half (45%) do not recognize genetics as a risk factor of heart disease, according to the results of a recent survey commissioned by Novartis. Awareness of Lp(a) is even lower, with just 22% of respondents reporting they had heard of a test for the biomarker, while only 7% had taken it.

“Cardiovascular disease remains one of the leading causes of death in India, and awareness of risk factors such as elevated Lp(a) is critical,” said Dr. A. Sreenivas Kumar, Director, Cardiology, Apollo Hospitals, India. “South Asians are particularly vulnerable — in fact, 34% of Indian acute coronary syndrome patients have high Lp(a).⁸ When combined with common risk factors such as diabetes, obesity, and hypertension, the likelihood of heart attack or stroke increases dramatically. Lp(a) testing is essential to identify high-risk individuals early and help prevent avoidable cardiac events.”

“Too many people across India are unaware that a simple blood test can reveal their genetic risk from elevated Lp(a),” said Ram Khandelwal, Founder of Heart Health India Foundation. “We need to build widespread awareness and educate communities nationwide, so early testing becomes a natural part of heart health and not just something people consider after a significant cardiac event.”

“Testing for Lp(a) is a vital step in preventing heart attacks and saving lives,” said Amitabh Dube, Country President & Managing Director, Novartis India. “At Novartis, we have been advancing cutting-edge research for over three decades, while also expanding patient access to transformative therapies, so that millions of Indians at risk can take proactive steps to protect their heart health.”

From Patients to Policy: A Global Call to Action

The session brought together leading voices from patient advocacy groups, medical science, and healthcare policy:

·         Patient’s Perspective: Ram Khandelwal, who survived a heart attack at age 33, shared how the experience inspired his advocacy work for India’s first heart patient support group Heart Health India Foundation, and drove his efforts to raise the alarm on the dangers of elevated Lp(a) among its members.

·         Scientific Insights: Prof. Gerald Watts, an expert in Cardio-Metabolic Medicine, University of Western Australia, explained the genetic science behind elevated Lp(a) and its impact on cardiovascular health.

·         Policy Lens: Nicola Bedlington, Senior Policy Advisor/Project Lead, Lp(a) International Taskforce, FH Europe Foundation (FHEF), urged policymakers to embed Lp(a) testing into national CVD guidelines to close critical care gaps. Supporting this, Prof. Zanfina Ademi, Professor, Health Economics, Monash University; Lp(a) International Task Force, FH Europe Foundation highlighted the cost-effectiveness of Lp(a) testing and its economic impact on health systems and society in the region.

·         Cross-Regional Dialogue: Experts from India, Korea Australia, and the Middle East (including Dr. A. Sreenivas Kumar from Apollo Hospitals India and Prof. Youngwoo Jang from Gachon University Gil Medical Center) addressed the challenges in diagnosing and managing elevated Lp(a), and the potential economic benefits of testing for it.

The webinar concluded with a unified call to action to expand Lp(a) testing across the Asia Pacific and Middle East region, embed diagnosis and management of elevated Lp(a) into health systems with supportive policies.