Guwahati: A major two-year retrospective autopsy study conducted at Assam Medical College and Hospital (AMCH) has revealed that cardiovascular diseases account for more than half of all sudden natural deaths (SND) in the region, with coronary artery disease emerging as the single largest cause.
The findings, based on detailed post-mortem examinations, highlight an urgent public health crisis driven by lifestyle factors and limited awareness among Assam’s population.
Researchers analysed 3,623 medico-legal autopsies conducted at AMCH between January 2023 and December 2024. Of these, 205 cases (5.65 per cent) were classified as sudden natural deaths occurring within 24 hours of symptom onset or hospital admission, with no prior history of injury, poisoning, or known chronic illness.
The study, titled “Unforeseen Demise: A Two-Year Retrospective Study of Sudden Natural Deaths,” provides one of the most comprehensive post-mortem profiles of sudden natural deaths in Northeast India to date.
Males constituted a striking 78.04 per cent of the victims (160 cases), while females accounted for 21.95 per cent. The 41–60 age group was the hardest hit, representing 50.24 per cent of cases (103 deaths), followed by those above 60 years at 20.48 per cent. Married individuals made up 66.34 per cent of the deceased, suggesting that family and social structures alone offer limited protection against these silent killers.
Cardiovascular diseases topped the list, accounting for 53.65 per cent of sudden natural deaths (110 cases), with coronary artery disease alone responsible for 47.80 per cent (98 cases). Respiratory disorders followed at 17.56 per cent (36 cases), including 9.21 per cent due to lobar pneumonia. Neurological conditions accounted for 12.68 per cent (26 cases), while gastrointestinal issues made up 8.78 per cent.
The pattern mirrors global trends but also highlights Assam-specific vulnerabilities such as high tobacco use, stress, sedentary lifestyles, and poor access to preventive cardiac screening in rural and semi-urban areas.
Lead author Dr Nayan Kumar Das, Associate Professor of Forensic Medicine at Nalbari Medical College, along with co-investigators from AMCH — Dr Gurjeet Singh Juneja, Dr Swaraj Phukon, Dr Chinmay Kakati, and Dr Nandini Pegu — emphasised that autopsy remains the gold standard for determining the precise causes of sudden death.
“These deaths are preventable with early detection and lifestyle intervention,” the researchers noted, calling for statewide cardiovascular health campaigns and better integration of forensic data into public health policy.
Health experts in Assam have welcomed the study as a wake-up call. With over 3,600 autopsies reviewed, the data offers rare evidence-based insights for policymakers grappling with the rise of non-communicable diseases in the state.
Authorities are now being urged to prioritise community-level heart health initiatives to curb this hidden epidemic.
The full research was published in the European Journal of Cardiovascular Medicine (Volume 15, Issue 7, July 2025).