Heart disease and diabetes disproportionately affect young South Asians, even those living outside South Asia. This is known as the “South Asian paradox” as risk factors like smoking are often absent.
Genetics is thought to play a role given the large population numbers and geographical spread affected, but few genetic studies have included South Asians. This is starting to change with large genome sequencing projects in India, the US and Europe.
Some genetic mutations and variants increasing cardiometabolic risk have been found only or predominantly in South Asian populations, offering clues and potential drug targets. However, genetics alone cannot fully explain the disparities.
Social and environmental factors like physical inactivity, lifelong diet patterns, stress from racism and migration also contribute. Interventions addressing these non-genetic factors through lifestyle and social support programs have shown promise in reducing risk.
While more genetics research could help prediction and precision medicine, some argue greater focus is needed on understanding and addressing the social determinants of health through community-engaged approaches. This could help explain more of the risk disparities and have a larger public health impact.
Both genetic and non-genetic risk factors likely interact in complex ways. An integrated approach focusing on both biological and sociocultural influences is favored by many researchers to best understand and improve heart health in South Asian communities.
Source: Nature
