Lipids in South Asians: Epidemiology and Management

  • Minhal Makshood
  • Wendy S. PostEmail author
  • Alka M. Kanaya
Lipids (E. Michos, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Lipids


Purpose of Review

This review focuses on lipoprotein abnormalities in South Asians (SA) and addresses risk stratification and management strategies to lower atherosclerotic cardiovascular disease (ASCVD) in this high-risk population.

Recent Findings

South Asians (SAs) are the fastest growing ethnic group in the United States (U.S) and have an increased risk of premature coronary artery disease (CAD). While the etiology may be multifactorial, lipoprotein abnormalities play a key role. SAs have lower low-density lipoprotein cholesterol (LDL-C) compared with Whites and at any given LDL-C level, SA ethnicity poses a higher risk of myocardial infarction (MI) and coronary artery disease (CAD) compared with other non-Asian groups. SAs have lower high-density lipoprotein cholesterol (HDL-C) with smaller particle sizes of HDL-C compared with Whites. SAs also have higher triglycerides than Whites which is strongly related to the high prevalence of metabolic syndrome in SAs. Lipoprotein a (Lp(a)) levels are also higher in SAs compared with many other ethnic groups. This unique lipoprotein profile plays a vital role in the elevated ASCVD risk in SAs. Studies evaluating dietary patterns of SAs in the U.S show high consumption of carbohydrates and saturated fats.


SAs have a high-risk lipoprotein profile compared with other ethnicities. Lipid abnormalities play a central role in the pathogenesis of CAD in SAs. More studies are needed to understand the true impact of the various lipoproteins and their contribution to increasing ASCVD in SAs. Aggressive lowering of LDL-C in high-risk groups using medications, such as statins, and lifestyle modification including dietary changes is essential in overall CAD risk reduction.


Lipids South Asians Dyslipidemia MASALA Low-density lipoprotein High-density lipoprotein 



American College of Cardiology/American Heart Association


Action to Control Cardiovascular Risk in Diabetes


Acute myocardial infarction


Atherosclerotic cardiovascular disease


Coronary artery calcium


Coronary artery disease


Carotid artery–intima media thickness


Cholesteryl ester transfer protein


Coronary vascular disease


Fenofibrate Intervention and Event Lowering in Diabetes


Further Cardiovascular Outcomes Research with PCSK9 Inhibition in Subjects with Elevated Risk


High-density lipoprotein cholesterol


Internal carotid artery intima-media thickness


Improved Reduction of Outcomes: Vytorin Efficacy International Trial


Low-density lipoprotein cholesterol


Lipoprotein a


The Mediators of Atherosclerosis in South Asians Living in America


Multi-Ethnic Study of Atherosclerosis


Metabolic syndrome


Pooled cohort equation


Proprotein convertase subtilisin/kexin type 9


South Asians


Very low-density lipoprotein cholesterol


Compliance with Ethical Standards

Conflict of Interest

Minhal Makshood, Wendy Post, and Alka Kanaya declare that they have no conflicts of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Minhal Makshood
    • 1
  • Wendy S. Post
    • 2
    Email author
  • Alka M. Kanaya
    • 3
  1. 1.Johns Hopkins UniversityBaltimoreUSA
  2. 2.Johns Hopkins UniversityBaltimoreUSA
  3. 3.University of California. San FranciscoSan FranciscoUSA

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