South Asians face 2.5x higher heart disease risk, major US study finds

South Asian individuals (people who trace their ancestry from Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan, and Sri Lanka) have high rates of atherosclerotic cardiovascular disease (ASCVD), with estimates approximating rates 2.5 times higher compared with non‐Hispanic White and East Asian populations, a new study published in the Journal of the American Heart Association (JAHA) reveals.What does that mean? People from South Asia that includes those with family roots in India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan, and the Maldives tend to get serious heart disease much more often than many other groups around the world. Atherosclerotic cardiovascular disease (ASCVD) is basically when the blood vessels that supply the heart and brain slowly get clogged with fat, cholesterol, and inflammation.

Over time, this can lead to heart attacks and strokes. Study shows that South Asians have about 2.5 times higher risk of developing this kind of heart disease compared to White and East Asian populations. And this often happens earlier in life, sometimes even in the 40s or 50s.Researchers examined the MASALA (Mediators of Atherosclerosis in South Asians Living in America) and the MESA (Multi‐Ethnic Study of Atherosclerosis) cohort studies.

The study identified clinical risk factors hypertension, prediabetes or diabetes status, dyslipidemia, and body mass index (BMI) contributing to the heart condition. "Behavioral risk factors included alcohol use, physical activity (PA) level, and diet quality. Alcohol use was defined as currently drinking ≥1 drinks per week. Participants reported exercise using the Typical Week’s Physical Activity Questionnaire, which was quantified as metabolic equivalent of task min/wk," the researchers have said.

Time to rethink screening paradigms: Clinicians need to adopt more aggressive screening strategies for South Asian patients in 20s and 30s

“The recent longitudinal analysis published in Journal of the American Heart Association highlights an important and evolving trend: South Asians, including middle-aged adults, continue to exhibit a disproportionately high burden of cardiovascular risk factors compared to other racial and ethnic groups in the United States. This is consistent with what we observe clinically and what our ongoing Beat by Beat reports repeatedly underscore — that genetic predisposition, cultural diet patterns, body fat distribution, and metabolic risk clustering all play a role in accelerating cardiovascular risk among South Asians," Dr.

Joy Shome , Head - TAVI/TAVR - BM Birla Heart Hospital told TOI Health."What stands out in this study is the trajectory of risk factors over time, even among individuals who initially appear healthy. Traditional risk markers such as hypertension, diabetes, dyslipidaemia and central obesity are not only more prevalent but also tend to progress more rapidly among South Asians. This emphasizes the need to rethink our screening paradigms: waiting until overt disease manifests is less effective than identifying and managing risk early.

From a preventive cardiology perspective, this has several implications. First, clinicians must adopt earlier and more aggressive screening strategies for South Asian patients, ideally beginning in their 20s and 30s, rather than the usual middle-age thresholds. Second, risk assessment needs to go beyond conventional markers; tools that incorporate ethnicity-specific risk profiles and metabolic indicators are essential.

Third, lifestyle interventions — tailored to cultural preferences and real-world constraints — must be reinforced at the community level," Dr Joy Shome adds."Importantly, it also reminds us that cardiovascular risk is modifiable. While genetic predisposition sets the stage, behavioural and environmental factors — diet, physical activity, stress management and timely medical follow-ups, determine the outcome. Awareness among patients and providers alike must shift from “treatment when sick” to prevention when healthy. That is the critical takeaway not only for clinicians but for public health planning,” the doctor urges.Medical experts consulted This article includes expert inputs shared with TOI Health by: Dr. Joy Shome , Head - TAVI/TAVR - BM Birla Heart HospitalInputs were used to explain the findings of a study that says that South Asian individuals are prone to heart diseases.