Published Sep 20, 2026 | 7:00 AM ⚊ Updated Sep 20, 2026 | 7:00 AM
The numbers were considerably lower in the other three major southern states.
Synopsis: Tamil Nadu recorded 29,740 medically certified deaths from heart attacks in 2024, accounting for around 33.5 percent of the 88,776 such deaths reported across India. Data from the Medical Certification of Cause of Death (MCCD) system shows also show a substantial burden from stroke, hypertension, diabetes and liver disease across southern states. Nationally, medically certified deaths represented just 23.1 percent of all registered deaths in 2024.
Tamil Nadu recorded the highest number of medically certified deaths due to heart attacks in India in 2024, accounting for more than a third of all such deaths reported under the Medical Certification of Cause of Death (MCCD) system, according to the latest report of the Registrar General of India.
The state recorded 29,740 medically certified deaths due to acute myocardial infarction, the medical term for a heart attack, out of 88,776 such deaths reported across the country. This means Tamil Nadu accounted for around 33.5 per cent of all medically certified heart attack deaths recorded under the system.
Karnataka followed with 9,065 medically certified heart attack deaths. The numbers were considerably lower in the other three major southern states, with Telangana reporting 736 deaths, Andhra Pradesh 564 and Kerala 342.
The figures, however, need to be read with an important caveat. The MCCD report does not capture every death in the country. It records deaths for which the cause was medically certified, and the extent of such certification varies considerably between states.
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The broader picture in the report shows the importance of cardiovascular disease in India’s mortality profile. Diseases of the circulatory system accounted for 38.8 per cent of all medically certified deaths reported nationally in 2024, making it the largest major cause group.
Diseases of the respiratory system were a distant second, accounting for 11 per cent of medically certified deaths.
The circulatory disease category, however, covers several different conditions. Diseases of pulmonary circulation and other forms of heart disease constituted 53.3 per cent of deaths within the circulatory disease group, while ischaemic heart disease accounted for 22.5 per cent. Cerebrovascular diseases, which include stroke, accounted for 10.8 per cent, while hypertensive diseases made up 10.2 per cent.
Heart attacks form part of the ischaemic heart disease category. The MCCD report separately records acute myocardial infarction and other forms of ischaemic heart disease.
The age profile of these deaths shows a strong concentration among older people. Of the 88,776 medically certified deaths from acute myocardial infarction nationally, 38,133 occurred among people aged 70 years and above. Another 19,647 deaths were recorded among people aged 55 to 64 years.
The sex pattern also varied by age. Among people aged 70 years and above, the report recorded 18,978 male and 19,155 female deaths from acute myocardial infarction.
Tamil Nadu’s numbers stand out not only among southern states but also in the national data.
The state recorded 29,740 medically certified acute myocardial infarction deaths in 2024, compared with 9,065 in Karnataka. Andhra Pradesh recorded 564, Telangana 736 and Kerala 342.
The figures suggest a substantial burden of cardiovascular deaths being captured through the medical certification system in Tamil Nadu. But they cannot, on their own, be interpreted as showing that Tamil Nadu necessarily has a higher incidence of heart attacks than other states.
That is because the proportion of deaths receiving medical certification differs sharply across the country.
In Tamil Nadu, medically certified deaths accounted for 38.7 per cent of all registered deaths in 2024. The corresponding figure was 27.5 per cent in Karnataka, 19.3 per cent in Andhra Pradesh, 38.3 per cent in Telangana and only 10.7 per cent in Kerala.
At the national level, just 23.1 per cent of registered deaths were medically certified in 2024.
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Looking at the broader category of ischaemic heart disease produces a similar pattern.
India recorded 1,80,290 medically certified deaths from ischaemic heart disease in 2024. Tamil Nadu accounted for 56,238 of these deaths, or about 31 per cent of the national total. Karnataka recorded 16,324 deaths.
Kerala reported 3,454 medically certified deaths from ischaemic heart disease, while Telangana recorded 1,645 and Andhra Pradesh 850.
The distinction between acute myocardial infarction and the broader ischaemic heart disease category is important. A heart attack is one form of ischaemic heart disease, but not every death classified under ischaemic heart disease is recorded specifically as an acute myocardial infarction.
In Tamil Nadu, for instance, the 29,740 acute myocardial infarction deaths formed more than half of the state’s 56,238 medically certified ischaemic heart disease deaths.
The report also shows a significant burden from cerebrovascular diseases, which include stroke.
India recorded 86,300 medically certified deaths from cerebrovascular diseases in 2024. Maharashtra recorded the highest number at 14,644, followed by West Bengal at 14,603.
Tamil Nadu recorded 9,040 deaths, while Karnataka reported 7,223. Andhra Pradesh recorded 2,830, Kerala 2,375 and Telangana 2,065.
The data show that cardiovascular mortality extends well beyond heart attacks. Across the MCCD classification, heart disease, cerebrovascular disease and hypertension together account for a substantial share of medically certified deaths.
Hypertensive diseases accounted for 81,928 medically certified deaths across India in 2024.
Punjab recorded the highest number at 16,163, followed by Maharashtra with 14,869. Tamil Nadu recorded 7,274 medically certified deaths, while Karnataka reported 3,727.
Kerala recorded 1,677 deaths, compared with 179 in Andhra Pradesh and 122 in Telangana.
The report recorded a relatively small difference between men and women nationally, with 40,363 male deaths and 41,563 female deaths attributed to hypertensive diseases.
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Diabetes presents a different pattern in the MCCD data.
The country recorded 61,977 medically certified deaths due to diabetes mellitus in 2024. Maharashtra recorded 21,161 deaths and Tamil Nadu 9,528.
Among the southern states, Kerala recorded 5,495 medically certified diabetes deaths, higher than Karnataka’s 3,537. Andhra Pradesh recorded 551 and Telangana 215.
More significant than the absolute number is the proportion of medically certified deaths attributed to diabetes in Kerala. Diabetes accounted for 16.4 per cent of all medically certified deaths in the state, the highest proportion reported among all states and Union Territories. The corresponding national proportion was 3 per cent.
The MCCD report shows that diabetes deaths were overwhelmingly concentrated among older adults. People aged 70 years and above accounted for 39.5 per cent of medically certified diabetes deaths nationally, while those aged 55 to 64 accounted for another 24.1 per cent.
The pattern changes when the MCCD data turn to liver disease, where the gap between men and women is particularly stark.
India recorded 61,415 medically certified deaths from diseases of the liver in 2024. Of these, 50,592 were men and 10,823 were women, meaning men accounted for 82.4 per cent of all medically certified liver disease deaths.
Karnataka recorded 9,588 such deaths, the second-highest number nationally after Maharashtra, which reported 13,804. Tamil Nadu recorded 5,669 liver disease deaths, while Kerala reported 1,828, Andhra Pradesh 781 and Telangana 681.
Karnataka’s figure accounts for 15.6 per cent of all medically certified liver disease deaths recorded in India, giving the state a notably large share of the national total.
The MCCD data, however, do not explain what is driving this pattern. They record the medically certified cause of death but do not establish whether the deaths were linked to alcohol consumption, metabolic liver disease, delayed diagnosis or other factors.
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The MCCD data offer an important insight into how cause-of-death information is recorded in India, but they also expose the limitations of comparing states using absolute numbers alone.
Nationally, medically certified deaths represented 23.1 per cent of all registered deaths in 2024. However, among deaths where the deceased had received some form of medical attention during the terminal illness, medical certification covered 63 per cent.
The difference between the two measures was particularly large across states.
Tamil Nadu medically certified 38.7 per cent of all registered deaths, while 97 per cent of deaths in which the deceased had received medical attention during the terminal illness were medically certified. Karnataka recorded corresponding figures of 27.5 per cent and 86.2 per cent.
In Kerala, however, only 10.7 per cent of all registered deaths were medically certified, and the proportion was 16 per cent among deaths where the deceased had received medical attention during the terminal illness.
Telangana presents another contrast. While 38.3 per cent of all registered deaths were medically certified, only 39.4 per cent of deaths involving medical attention during terminal illness were medically certified.
The Registrar General’s report itself cautions that medical certification remains incomplete nationally and that considerable differences exist between states. In 2024, coverage ranged from 3.6 per cent of registered deaths in Bihar to 100 per cent in Goa.
(Edited by Dese Gowda)
