South Asians

South Asians are a rapidly growing population in the United States. There has been some special interest in this group because they have been reported to have very high prevalence rates of coronary disease at younger ages in the absence of traditional risk factors. 1063 The higher CHD risk in this population may be related in part to a higher prevalence of insulin resistance, the metabolic syndrome, and diabetes. Lipoprotein (a) levels have also been reported to be elevated1064 although its contributions to the observed increased CHD risk are unclear. Efforts to reduce cholesterol and other CHD risk factors in this group with South Asian Indian ancestry appear to be especially important.

In summary, a growing body of evidence indicates that South Asians are at high baseline risk for CHD, compared to American whites. They are particularly at risk for the metabolic syndrome and type 2 diabetes. For this reason, the ATP III panel advises that special attention should be given to detection of CHD risk factors in South Asians. Also, increased emphasis should be given to life habit changes to mitigate the metabolic syndrome in this population. Otherwise, cholesterol management guidelines are the same as those for other population groups.