American Society for Preventive Cardiology issues first comprehensive care playbook tailored to South Asian communities in North America.

A new clinical practice statement led by cardiologist Anand Rohatgi, MD, lays out a practical framework to prevent and manage heart and metabolic disease among people of South Asian (SA) origin—one of the fastest‑growing groups in the U.S. and Canada and one that carries a disproportionately high burden of coronary disease and type 2 diabetes. The guidance spans care for individuals, families, clinics, and entire communities.  

Why this matters

Multiple studies show South Asians have nearly double the risk of coronary artery disease compared with people of European ancestry—and about half of that excess risk persists even after accounting for common factors like blood pressure, cholesterol, and lifestyle. Yet South Asians remain under‑represented in genetic and clinical datasets (≈1.3% of genome‑wide studies), making it harder to deliver precision prevention.  

What’s new in the statement

• Earlier, tailored screening. The authors urge clinicians to screen at lower BMI thresholds, routinely measure waist circumference, and look for fatty liver disease (using labs such as FIB‑4, ultrasound, or elastography) when triglycerides or liver enzymes are elevated or when prediabetes/diabetes is present. These steps reflect how risk can rise in South Asians even at lower body weights.  
• Smarter heart‑risk imaging. A visual clinical decision pathway (see Fig. 10 on page 14) shows how coronary artery calcium (CAC) scoring can refine risk estimates and guide prevention (for example, intensifying lipid‑lowering therapy when calcium is present). The paper also highlights when coronary CT angiography (CCTA) and plaque characteristics might add value, and calls for research on how a CAC score of 0 should be interpreted in adults over 75.  
• Mental health is part of heart health. The framework integrates routine mental‑health screening (e.g., VitalSign6) and points to the SHAKTI study, which is tracking biological and psychosocial drivers of resilience and depression in South Asians—recognizing that stress, depression, and anxiety can amplify cardiometabolic risk.  
• Clinic design that fits culture and daily life. The paper outlines key elements of South Asian cardiometabolic prevention clinics—multidisciplinary teams (cardiology, endocrinology, dietetics, mental health), culturally appropriate nutrition counseling, language accommodations, and partnerships with faith‑based and community groups to improve access (see the infographic on page 18, Fig. 13). The goal: make high‑quality prevention easy to reach and easy to use.  
• Community engagement and policy. The statement recommends community‑engaged research, patient/stakeholder advisory boards, and health‑system partnerships to address social determinants of health—from insurance gaps to transportation—summarized in Table 10 and the community engagement figure on page 20 (Fig. 14).    

For readers: what to ask your care team

• “Do South Asian–specific factors change my risk?” (Ask about earlier diabetes screening, waist circumference, and whether fatty liver screening is appropriate.)  
• “Would a coronary calcium score help personalize my prevention plan?” (Especially when your calculated 10‑year risk is borderline or uncertain.) See Fig. 10 for how CAC informs decisions.  
• “Can I get nutrition and mental‑health support that reflects my culture and language?” (The statement encourages clinics to build exactly these services.)  
• “Should I know my lipoprotein(a) level or consider other advanced markers?” (The pathway highlights markers that can be more common in South Asians.)  

Bottom line

This is the first end‑to‑end, South Asian–focused prevention roadmap from a major U.S. society. It calls for earlier detection, culturally tailored care, judicious use of heart imaging, and community partnerships to bend the curve on heart disease and diabetes in South Asian communities—while accelerating research that finally reflects this population’s size and risk.  

Source: Rohatgi A, Anand SS, Gadgil M, et al. “South Asians and cardiometabolic health: A framework for comprehensive care…” American Journal of Preventive Cardiology (2025).  

Editor’s note: This article is informational and not a substitute for personal medical advice.