Atherosclerotic Cardiovascular Disease in South Asians: Epidemiology, Risk Factors, and Management

Cardiovascular disease remains a leading cause of morbidity and mortality worldwide, with South Asians carrying a disproportionate burden. Compared to other ethnic groups, South Asians experience a decade earlier onset of atherosclerotic cardiovascular disease, often before age 60, and have higher rates of ischemic heart disease and stroke. This elevated risk reflects a complex interaction of biological, environmental, and sociocultural factors that are not fully accounted for by existing research models. This review summarizes current evidence on the epidemiology, pathophysiology, and risk factors contributing to the atherosclerotic cardiovascular disease risk in South Asians. Key risk factors include hypertension, diabetes, dyslipidemia, central obesity, and dietary patterns high in refined carbohydrates and saturated fats. Nontraditional factors—such as elevated pro-inflammatory biomarkers and epigenetic programming—may further accelerate atherosclerosis in this population. Despite progress in reducing mortality, underrepresentation in cardiovascular research and limited access to preventive care continue to hinder effective management. Culturally tailored prevention programs and earlier screening, combined with advancements in research, are critical to improving outcomes. Collaborative efforts across research and clinical practice are needed to reduce the burden and create effective interventions.