Why Heart Disease Risk Is Higher in South Asians And What You Can Do About It
Why Heart Health Month Matters More Than Ever
Heart Health Month is always a meaningful time for me as a physician who focuses on prevention, weight management, and metabolic health. Cardiovascular disease continues to be the leading cause of death worldwide, yet so much of it is influenced by factors we can identify and improve early.
What makes this conversation especially important is recognizing that heart disease does not impact all populations equally. South Asians in particular carry a significantly higher risk, and this is something I talk about with patients often because it is still widely underrecognized.
The Hidden Risk: Why South Asians Develop Heart Disease Earlier
South Asians, including individuals with ancestry from India, Pakistan, Bangladesh, Sri Lanka, and Nepal, tend to develop heart disease at younger ages and at lower body weights compared to many other populations.
Many people assume that if they are not overweight or do not have obvious symptoms, their heart health is fine. Unfortunately, that is not always true in this group. I regularly see patients who appear metabolically healthy on the surface but have underlying risk factors that place them at higher cardiovascular risk.
When BMI Doesn’t Tell the Full Story
One of the biggest contributors is the way body fat is distributed. South Asians are more likely to store visceral fat, which is fat that accumulates around internal organs. This type of fat is strongly associated with insulin resistance, inflammation, and plaque buildup in arteries. Someone can have a normal body mass index but still carry excess visceral fat, which means traditional measures like BMI do not always give the full picture.
The Genetic Factors That Increase Cardiovascular Risk
There is also a strong genetic component. South Asians have higher rates of insulin resistance, type 2 diabetes, and abnormal cholesterol patterns. A common pattern I see is relatively normal LDL cholesterol but elevated triglycerides and low HDL cholesterol. This combination increases the risk of heart disease and often goes undetected if screening is not comprehensive. Additionally, lipoprotein(a), a genetically influenced cholesterol particle that increases cardiovascular risk, is often elevated in South Asian populations and is not routinely tested.
Cultural Foods and Cardiovascular Health Can Coexist
Dietary patterns and lifestyle shifts also play a role. Traditional South Asian diets can be rich in refined carbohydrates, fried foods, and saturated fats, especially as cultural eating habits blend with Western convenience foods. Rice, naan, sweets, and packaged snacks are staples in many households, and portion sizes can increase over time. Food is deeply tied to culture and family, which makes change feel emotionally and socially complicated. My goal is never to ask patients to abandon cultural foods but rather to help them modify preparation methods, balance portions, and build meals that support metabolic health while still honoring tradition.
Movement as Medicine: Why Strength Training and Daily Activity Matter
Physical activity patterns can also contribute. Many South Asian adults have sedentary work lifestyles and may not prioritize structured exercise. Even small increases in daily movement can have a powerful impact on blood sugar regulation, blood pressure, and cholesterol levels. Strength training is especially important because improving muscle mass helps reduce insulin resistance, which is a key driver of cardiovascular disease in this population.
The Overlooked Role of Stress in Cardiovascular Disease
Another factor that deserves attention is stress. Many South Asian families carry multigenerational expectations around career success, caregiving responsibilities, and social obligations. Chronic stress affects sleep, hormonal balance, and inflammation, all of which contribute to heart disease risk. Stress management is not a luxury when we talk about prevention. It is a medical necessity.
Why South Asians Should Consider Earlier Screening
Heart Health Month is a reminder that prevention starts earlier than most people think. For South Asian adults, I often recommend screening for diabetes, cholesterol abnormalities, and blood pressure beginning at younger ages, sometimes in the late twenties or early thirties depending on family history. Waiting until symptoms appear can mean missing a critical window where lifestyle changes and early treatment can significantly reduce long-term risk.
The Encouraging Truth: Cardiovascular Risk Is Highly Modifiable
There is encouraging news in all of this. Cardiovascular risk is highly modifiable. Thoughtful nutrition changes, consistent physical activity, improved sleep habits, and when appropriate, medication can dramatically reduce risk. Even modest weight loss or improved blood sugar control can lead to measurable improvements in cardiovascular markers. I encourage patients to think about heart health as a long-term investment rather than a short-term goal. Small sustainable changes often outperform extreme plans that are difficult to maintain. The most effective prevention strategies are the ones that fit into your real life, your culture, and your routines.
Heart Health as a Family Conversation
Heart Health Month is an opportunity to start conversations within families as well. South Asian families often share genetic risk and lifestyle patterns, which means prevention can become a shared effort. Encouraging parents, siblings, and even younger family members to get screened and prioritize metabolic health can create ripple effects across generations.