Guidelines target high cardiometabolic risk among South Asians
UTSW faculty, global colleagues recommend early screening, nutrition advice, research improvements to reduce heart disease
DALLAS – June 02, 2025 – People of South Asian descent make up one-quarter of the world’s population, but they account for 60% of cardiovascular disease cases. To help reduce the elevated risk of heart disease among South Asians living in North America, UT Southwestern Medical Center researchers joined global colleagues in developing comprehensive recommendations, published in the American Journal of Preventive Cardiology, for health care providers, patients, community members, and policymakers.
Anand Rohatgi, M.D., Professor of Internal Medicine in the Division of Cardiology at UT Southwestern, conceived the idea of a framework to address the higher risk of heart disease, diabetes, and hypertension in South Asians compared with other races and ethnicities. Known as cardiometabolic disorders, these and other conditions can affect South Asians even at normal weights and can be overlooked during routine examinations.
“There’s a lot of background evidence on elevated heart disease risk in South Asians, but a lack of prospective programming and interventions for prevention and management,” Dr. Rohatgi said. “It occurred to us that health care providers and other stakeholders could use a road map to identify gaps in clinical care and research while addressing how we can collectively move forward.”
Over 5 million U.S. residents are from South Asian countries including India, Pakistan, Bangladesh, Nepal, Sri Lanka, Maldives, and Bhutan, and more than 2 million live in Canada.
Genetic, cultural, and environmental influences combine to raise South Asians’ cardiometabolic disease risk. They develop coronary heart disease, the leading cause of death worldwide, at two to four times the rates of other ethnic groups. They also tend to develop hypertension earlier and more often, are less likely to take medications to control it, and are at a greater risk of developing Type 2 diabetes at younger ages and lower body mass indexes (BMI). South Asian women have higher rates of adverse pregnancy outcomes, further exacerbating risk from younger ages.
The authors said clinicians should be proactive about preventive care of South Asian patients by screening earlier for blood glucose levels, body composition, arterial plaque, mental health, genetic risk, and potential for adverse pregnancy outcomes.
South Asians may benefit from lifestyle modifications or medications despite “normal” test results, the authors said. At UT Southwestern’s South Asian Heart Program in Coppell, which Dr. Rohatgi started in 2022, clinicians model this proactive approach using comprehensive evaluation and counseling.
The authors explained that foundational studies on the accuracy of medical tests and patient responses to health interventions are lacking for South Asian populations. While efforts to include South Asians in clinical research have been slow, some patients are also skeptical about the safety of participating. This report could help drive funding for research and recruitment efforts, the authors indicated.
Language barriers and cultural norms, such as lack of exercise and preferences for alternative medicines, also may contribute to disease risk, the authors noted, along with the scarcity of dietary advice that includes healthy South Asian dishes. The authors suggested collaborations between South Asian community leaders and health care workers to help patients make healthy dietary and lifestyle choices.
“Our biggest takeaway is that people who are part of South Asian communities or who engage with them in any way, particularly in medicine, should become aware of the risk and take action to empower South Asians to lead healthy lives,” Dr. Rohatgi said.
Other UTSW researchers who contributed to the study are Manish Jha, M.D., Associate Professor of Psychiatry and an O’Donnell Clinical Neuroscience Scholar; Parag Joshi, M.D., Associate Professor of Internal Medicine in the Division of Cardiology; and Madhukar Trivedi, M.D., Professor of Psychiatry, Chief of the Division of Mood Disorders, and Director of the Center for Depression Research and Clinical Care. Drs. Jha and Trivedi are Investigators in the Peter O’Donnell Jr. Brain Institute.
About UT Southwestern Medical Center
UT Southwestern, one of the nation’s premier academic medical centers, integrates pioneering biomedical research with exceptional clinical care and education. The institution’s faculty members have received six Nobel Prizes and include 25 members of the National Academy of Sciences, 23 members of the National Academy of Medicine, and 14 Howard Hughes Medical Institute Investigators. The full-time faculty of more than 3,200 is responsible for groundbreaking medical advances and is committed to translating science-driven research quickly to new clinical treatments. UT Southwestern physicians provide care in more than 80 specialties to more than 140,000 hospitalized patients, more than 360,000 emergency room cases, and oversee nearly 5.1 million outpatient visits a year.