South Asians face double the risk of heart attack; 'It's the numbers, not the symptoms, that matter'; Dr. Sherin Abraham.

Health expert Dr. Sherin Abraham has issued a serious warning regarding cardiovascular diseases (CVD) for South Asian immigrants residing in the United States. She notes that the risk of heart attack or stroke for this group is nearly double compared to other communities, and these conditions are likely to appear a decade earlier. This message is critical given the increasing instances of sudden cardiac arrest in young adults without prior warning signs. 

Hidden Genetic Risks 

The primary reason for this heightened risk among South Asians is genetic. Inherited lipid disorders like Familial Hypercholesterolemia (FH) and elevated Lp(a) are more prevalent in this community. These conditions can dangerously increase LDL cholesterol (bad cholesterol) levels, even in individuals who appear physically fit.

 Waist Circumference Over BMI 

The traditionally used BMI measurements often underestimate the cardiovascular risk in the South Asian population. Due to the 'thin–fat phenotype' seen in this group, hazardous visceral fat can accumulate around internal organs even with a normal BMI. Therefore, Abdominal girth (waist circumference) is a more accurate indicator of cardiac risk than BMI. 

Strict Treatment Targets 

The optimal LDL target is not the same for everyone. Individuals with high risk, such as those with FH, must strictly maintain their LDL level below 100 mg/dL. Early testing for specific risk factors like Lp(a) and ApoB is crucial. In such cases, doctors recommend using statins and other medications as 'preventive medicine' to lower LDL. Furthermore, for those with consistently high LDL, a Coronary CT Angiogram is essential to detect soft plaque in the coronary arteries, as a Coronary Calcium Score alone is not reliable. 

Dr. Sherin's Key Advice 

Dr. Sherin's central piece of advice is: "Your numbers predict your future, not your symptoms." Therefore, early cardiology check-ups and strict LDL control are essential to overcome these risks.