New Guidelines Address Elevated Cardiometabolic Risks in South Asian Populations

South Asians constitute approximately 25% of the global population but are disproportionately affected by cardiovascular diseases, accounting for around 60% of cases. To combat this heightened risk, researchers from UT Southwestern Medical Center, in collaboration with international colleagues, have developed comprehensive guidelines aimed at improving health outcomes for South Asians living in North America. Published in the American Journal of Preventive Cardiology, these recommendations target healthcare providers, patients, community organizations, and policymakers.

Dr. Anand Rohatgi, a Professor of Internal Medicine at UT Southwestern, initiated the development of a framework to better understand and manage the elevated risks of heart disease, diabetes, and hypertension faced by South Asians. These conditions, often referred to as cardiometabolic disorders, can develop even among individuals with normal weight and may go unnoticed during routine health assessments.

The guidelines emphasize the importance of proactive screening. Clinicians are encouraged to evaluate blood glucose levels, body composition, arterial plaque buildup, mental health status, genetic risks, and potential pregnancy complications earlier than standard protocols suggest. Despite often presenting with 'normal' test results, many South Asians may benefit from lifestyle interventions or medications if risk factors are identified.

South Asians are genetically, culturally, and environmentally predisposed to higher rates of coronary heart disease—the leading cause of death worldwide—developing it at two to four times higher rates than other ethnic groups. They also tend to develop hypertension earlier, often with lower medication adherence, and are at increased risk for Type 2 diabetes at younger ages and lower BMI thresholds. Women in South Asian communities face additional risks, including adverse pregnancy outcomes, further increasing their disease burden.

The UT Southwestern South Asian Heart Program, established in 2022, exemplifies this proactive approach. The program offers comprehensive evaluations and counseling tailored to South Asian patients, aiming to mitigate long-term risks through early intervention.

Challenges to implementing these guidelines include limited data on the accuracy of medical tests within South Asian populations and skepticism toward clinical research participation. Additionally, cultural norms, language barriers, dietary habits, and preferences for traditional medicine can hinder effective healthcare delivery. The guidelines call for greater collaboration between community leaders and healthcare providers to promote healthy lifestyle changes.

Dr. Rohatgi emphasized the importance of awareness and proactive measures: "Healthcare professionals and community members should recognize the heightened risk among South Asians and take steps to empower individuals to lead healthier lives."

These guidelines serve as a vital step toward reducing the burden of cardiometabolic diseases in South Asian populations through targeted prevention, early detection, and culturally sensitive interventions.