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We were unable to process your request. Please try again later. If you continue to have this issue please contact customerservice@slackinc.com.<\/strong> <\/p>\nBack to Healio<\/button><\/p>\n<\/div>\n<\/div><\/div>\n<\/p><\/div>\n<\/p><\/div>\n<\/div>\n Key takeaways:<\/h2>\n\nSouth Asian adults have higher risk for adverse CV outcomes compared with other racial-ethnic groups.<\/li>\n Coronary calcium scans should be conducted for South Asian adults at age 40 to 45 years, regardless of BMI.<\/li>\n<\/ul>\nLAS VEGAS \u2014 South Asian adults have increased cardiovascular risk compared with other racial-ethnic groups and should undergo screening as early as age 40 years, according to a speaker. <\/p>\n
Multiple studies have found South Asian adults have increased risk for outcomes such as coronary artery disease, myocardial infarction and CV mortality, said <\/b>Rachna Relwani, MD,<\/b> an endocrinologist and founder of DesiDil in Atlanta. Additionally, Relwani said CV outcomes tend to occur earlier in South Asian adults than other racial-ethnic groups. During a talk at the American Association of Clinical Endocrinology Annual Scientific and Clinical Conference, Relwani explained why health care professionals should account for South Asian ethnicity during CV risk assessment and outlined steps they can take to detect risk for future adverse CV outcomes.<\/p>\n
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\u201cThe American Heart Association itself has recognized those of South Asian ethnicity as an independent risk factor,\u201d Relwani said during a presentation. \u201cThis is not a lifestyle failure. We need to change the conversation that we have with our patients.\u201d<\/p>\n
Data published in the Journal of the American Heart Association<\/i> in February revealed some of the increased risks South Asian adults in the U.S. face. In an analysis of data from the MASALA study and MESA, South Asian adults aged 45 to 55 years had higher prevalence of hypertension than white, Chinese and Hispanic adults. Additionally, South Asian men had higher rates of dyslipidemia than white, Chinese and Black men; and dyslipidemia was more common for South Asian women than Chinese and Black women.<\/p>\n
Relwani said South Asian adults tend to have higher amounts of visceral fat at lower BMIs than other racial-ethnic groups. That increased visceral fat is linked to higher insulin resistance, which then leads to dyslipidemia, higher triglycerides and low HDL cholesterol.<\/p>\n
Laboratory values to watch<\/h2>\n Most CV risk stratification systems tend to underpredict CV risk for South Asian adults, Relwani said. <\/p>\n
She said health care professionals have focused on LDL cholesterol as a biomarker for CV risk, but there are limitations to that approach. Relwani highlighted three other biomarkers \u2014 lipoprotein(a) \u2014 or Lp(a) \u2014 apolipoprotein B and C-reactive protein \u2014 that may be stronger predictors for CV risk in South Asian adults because they tend to have higher Lp(a) and ApoB levels than adults of other racial-ethnic groups.<\/p>\n
\u201cAll three of these are simple blood tests,\u201d Relwani said. \u201cYou can pretty much walk into any lab … and they cost $20 to $30, so they\u2019re fairly easy to order. They all also can significantly impact your management, and they all have therapies targeted directly to them.\u201d<\/p>\n
Relwani recommended that health care professionals assess all three biomarkers in addition to triglyceride-to-HDL cholesterol ratio and fasting insulin or homeostasis model of insulin resistance for South Asian adults. <\/p>\n
Imaging recommendations<\/h2>\n In addition to assessing laboratory values, health care professionals should consider a coronary calcium scan for South Asian adults, Relwani said, adding that the assessment can better detect subclinical CVD than a stress test. A study published in JACC: Advances <\/i>reported that 60% of South Asian men had a coronary artery calcium (CAC) score of more than 0 Agatston units at age 55 years.<\/p>\n
\u201cIt does have some limitations,\u201d Relwani said of CAC score. \u201cA score of 0 does not mean no risk. They may still have nonobstructive plaque, and so they recommend repeating the scan in about 5 years.\u201d<\/p>\n
Relwani said a CT angiogram can be used to assess nonobstructive plaque. A small study published in the Journal of the American College of Cardiology<\/i> in 2023 revealed South Asian adults had higher amounts of total plaque, calcified plaque and noncalcified plaque than white adults.<\/p>\n
\u201cOne of the takeaways from this is that if patients have calcified plaque on their coronary score, they also have noncalcified plaque,\u201d Relwani said. \u201cThat\u2019s something to be aware of. If you have calcified plaque, even if it\u2019s a small amount, you have coronary artery disease.\u201d<\/p>\n
Based on current evidence, Relwani said South Asian adults should be screened for CV risk with at least a CAC score by age 40 to 45 years, regardless of BMI, with a CT angiogram being conducted in select cases.<\/p>\n
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Sources\/Disclosures<\/h3>\n Source: <\/h2>\n Relwani R. Cracking the code: Uncovering hidden metabolic risk in South Asian hearts. Presented at: American Association of Clinical Endocrinology Annual Scientific and Clinical Conference; April 22-24, 2026; Las Vegas. <\/p>\n
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