South Asian families across Canada are facing a serious cardiovascular health challenge that researchers and doctors say can no longer be treated as a routine risk issue. People with roots in India, Pakistan, Bangladesh, Sri Lanka, Nepal, Bhutan and the Maldives have long been known to face higher rates of heart disease, diabetes and related metabolic conditions. Newer research is now helping explain why the risk often appears earlier, moves faster and can affect people who may appear healthy by standard medical measures.
According to the University of Toronto’s Temerty Faculty of Medicine, people of South Asian ethnicity make up about 25 percent of the global population but account for more than 50 percent of cardiovascular deaths worldwide. The same report highlighted research involving St. Michael’s Hospital and University of Toronto scientists that found South Asian patients with heart disease or diabetes had fewer vascular regenerative and reparative cells compared with white European patients. Researchers said this may point to a reduced ability to repair blood vessel damage, helping explain why heart disease can appear earlier and more aggressively in South Asian communities.
The concern is especially important in Canada, where South Asian communities are a major part of cities such as Brampton, Mississauga, Surrey, Calgary, Edmonton, Vancouver and Toronto. Heart & Stroke says people in Canada of South Asian descent are more than 1.5 times more likely to have heart conditions or stroke than people of European descent. The organization also notes that South Asian women in Canada face higher risks of diabetes and heart attack compared with white women in certain studies.
One of the biggest warning signs is prediabetes. A 2026 American Heart Association report found that South Asian adults in the United States showed heart disease risk factors at younger ages, even when they reported healthier lifestyle behaviours. At age 45, South Asian men were nearly eight times more likely to have prediabetes than white men, while South Asian women were about three times more likely to have prediabetes than white women.
This finding challenges the simple idea that South Asian heart risk is only about diet or poor habits. Researchers found that South Asian adults often reported healthier behaviours, including lower alcohol use, yet still showed higher rates of prediabetes, diabetes, hypertension and cholesterol problems. That does not mean lifestyle does not matter. It means the biological and metabolic starting point may be different, so prevention has to begin earlier and be more targeted.
Cholesterol risk is another major part of the picture. South Asians can have dangerous lipid patterns, including higher levels of lipoprotein(a), also known as Lp(a), and lower or less protective HDL cholesterol. A 2025 Journal of the American Heart Association study noted that South Asians have a higher prevalence of elevated Lp(a), with about 25 percent having levels above 50 mg/dL compared with many Western populations. Elevated Lp(a) is largely genetic and is linked to higher risk of early cardiovascular disease.
Because of these risks, standard timelines for heart screening may not be enough for South Asian families. Waiting until the 50s to take heart disease seriously can be too late for many people in this community. Blood pressure checks, A1c testing for diabetes risk, fasting glucose, cholesterol panels and discussions about family history should begin much earlier, especially for people with parents, siblings or close relatives who developed diabetes, high blood pressure, stroke or heart disease at a young age.
Doctors also need to consider South Asian ancestry as a meaningful risk factor during treatment decisions. The American College of Cardiology has noted that individuals of South Asian ancestry have about a twofold increased risk of atherosclerotic cardiovascular disease events compared with adults of European ancestry, and that current risk calculators may not fully capture this increased risk.
For families, the practical message is clear. South Asian patients should not wait for symptoms before asking about heart health. Chest pain, shortness of breath, unusual fatigue, jaw pain, arm pain, dizziness or sudden sweating should always be taken seriously. But prevention should start long before an emergency. Regular screening, earlier conversations with doctors, better diabetes prevention, improved sleep, stress control, strength training, walking and culturally realistic food changes can all play a role.
Diet changes should focus especially on blood sugar and insulin resistance. Many South Asian diets can be heavy in refined carbohydrates, white rice, white flour, sweets, fried snacks and large portions of starchy foods. A heart focused approach does not mean abandoning traditional food. It means adjusting portions, increasing lentils, beans, vegetables, nuts and whole grains, reducing deep fried foods, choosing healthier oils, limiting sugary tea and desserts, and balancing meals with more protein and fibre.
This is not a message of fear. It is a message of early action. South Asian families are not powerless against heart disease, but they do need a more aggressive prevention mindset. The latest research shows that this community faces a different risk profile, one shaped by metabolism, genetics, cholesterol patterns, diabetes risk and vessel repair differences. The sooner families recognize that reality, the better chance they have of preventing heart attacks, strokes and lifelong complications before they begin.
