Early Risk Factors for Heart Disease in U.S. South Asian Adults

 A growing body of research has identified early risk factors for heart disease among South Asian adults living in the United States, raising concerns within the medical community. Despite often appearing healthy and maintaining average body weight, many individuals from South Asian backgrounds face a disproportionately higher risk of developing cardiovascular disease at younger ages compared to other ethnic groups.

Studies show that South Asian adults—including those with roots in India, Pakistan, Bangladesh, Sri Lanka, and Nepal—tend to develop heart disease nearly a decade earlier than the general U.S. population. Researchers have been working to understand why this trend exists, and recent findings highlight several contributing risk factors that appear earlier and progress more aggressively.

One of the primary concerns is the higher prevalence of insulin resistance and type 2 diabetes within the South Asian community. Even individuals who are not visibly overweight may carry excess visceral fat—fat stored around internal organs—which significantly increases cardiovascular risk. This phenomenon is sometimes described as being “thin outside, fat inside,” making standard body mass index (BMI) measurements less reliable for assessing risk in this population.

Elevated cholesterol levels particularly high levels of lipoprotein(a), have also been identified as a key factor. Lipoprotein(a) is a genetic form of cholesterol linked to plaque buildup in arteries. Research suggests that South Asians are more likely to have elevated levels of this marker, increasing their chances of early heart attacks and strokes.

High blood pressure is another early warning sign commonly observed. Sedentary lifestyles, work-related stress, dietary habits rich in refined carbohydrates, and limited physical activity contribute to rising hypertension rates. Traditional diets that are high in fried foods, sugary sweets, and white rice may further elevate cardiovascular risk when combined with modern sedentary routines.

Family history plays a strong role as well. 

 Genetic predisposition means that even younger adults in their 30s and 40s may show early signs of arterial plaque buildup. Advanced imaging studies have revealed subclinical atherosclerosis—plaque accumulation without noticeable symptoms—in otherwise healthy South Asian adults.

Healthcare experts stress the importance of early screening and culturally tailored prevention strategies. Standard guidelines may not always reflect the specific risks faced by South Asians. For example, some medical professionals recommend lower BMI thresholds and earlier cholesterol screenings for individuals from this background.

Community awareness is equally vital. 

Lifestyle modifications such as increasing physical activity, reducing refined sugar intake, managing stress, and prioritising regular health check-ups can significantly reduce long-term risk. Even moderate changes, like walking daily and incorporating more fibre-rich foods into meals, can have measurable benefits.

Cardiovascular disease remains the leading cause of death globally, but early identification of risk factors provides an opportunity for prevention. For South Asian adults in the U.S., understanding their unique risk profile is the first step toward protecting heart health.

In conclusion, research underscores that early intervention, personalised screening, and lifestyle awareness are essential in addressing heart disease risk within the South Asian community. With targeted efforts, the trend of premature cardiovascular disease can be reduced, improving health outcomes for future generations.