As a South Asian cardiologist, I see patients frequently who are shocked to find out they have heart disease. Many are young, healthy and active people who have no risk factors. Some eat what they believe is a healthy home-cooked diet. But what they don’t always realize is that their background plays a major role in their risk for heart disease.
South Asians are more likely to develop heart disease at younger ages. Often, it shows up without the classic warning signs. It’s not just about lifestyle. A big part of the picture is our genetics.
Here are the traits I most often see that contribute to this higher risk.
1. Insulin Resistance
Many South Asians develop insulin resistance, which means the body does not respond well to insulin. This can lead to high blood sugar and eventually type 2 diabetes. It often shows up even in people who are not overweight. This condition increases the chances of developing plaque in the arteries.
2. High Cholesterol -> Low HDL and High Triglycerides
HDL is often called the “good” cholesterol, and it helps protect the heart. Many South Asians have lower HDL and higher triglycerides, which can increase the risk of blocked arteries and heart attacks.
3. High Lipoprotein(a) ( Lp(a))
Lp(a) is a type of cholesterol particle that is passed down through families, aka genetic. It is not usually checked on a regular blood test. High levels of Lp(a) can raise the risk of heart attacks and strokes. This is more common in South Asians than in other groups.
4. Belly Fat at Normal Weight
Some people look thin but carry fat around the belly and internal organs. This is called visceral fat and is more dangerous than fat stored in other parts of the body. South Asians often have more of this kind of fat, even if their weight is normal. This raises the risk of heart disease.
5. Family History of Early Heart Disease
If someone in your family had a heart attack or needed heart surgery before the age of 55 (for men) or 65 (for women), your own risk is higher. This kind of family history is more common in South Asians and should be taken seriously.
What You Can Do
Genetics do not mean you will definitely get heart disease. But if you know you are at higher risk, you can take steps early to help prevent it.
Here are a few simple steps I recommend:
- Ask your doctor to check your full cholesterol panel, including Lp(a)
- Get your blood sugar and insulin levels tested, even if you feel fine
- Eat fewer refined carbs like white rice, naan, and sweets
- Add fiber and protein to your meals to help balance blood sugar
- Move your body every day, even with a short walk after meals
- Try to reduce stress where you can, since stress affects the heart too
- Know your family history and share it with your doctor
Heart disease is common in our community, but it is not something we have to accept as normal. The more we understand our risks, the more we can do to protect our health and the health of the next generation.
