Elevated Risk for Cardiovascular Disease in Diasporic South Asians

Diasporic South Asians, individuals of South Asian descent who live outside their country of origin or heritage, are at a higher risk of developing cardiovascular diseases than the general population in many countries, including the United States. South Asians are also at elevated risk for specific cardiovascular risk factors, including Type 2 diabetes, obesity, metabolic syndrome, hypertension, dyslipidemia, and central distribution of fat (including visceral fat). The MASALA Study, a longitudinal cohort study of South Asians in the United States, found significantly elevated ectopic adiposity, increased insulin resistance, increased inflammatory markers, and decreased insulin sensitivity. To prevent cardiovascular disease, physicians and other medical providers must focus on mitigating known risks, including hypertension, diabetes, tobacco use, low physical activity levels, central obesity, coronary artery calcium (CAC), poor diet, and psychosocial factors. To proactively address these risks for South Asians, we must further educate healthcare providers, as well as advocate on behalf of South Asian people to ensure they have their blood pressure, cholesterol, and fasting glucose levels checked even if their BMI is normal or they follow a vegetarian diet. It is also essential to undertake culturally tailored outreach in specific South Asian communities to create educational materials regarding healthy behavior and lifestyle changes, including in languages needed by the most recent immigrants. Future research must include race, ethnicity, and native country of origin to better characterize the risk of stroke and heart attack and the impact of interventions among diasporic South Asian subgroups.