The Unsolved Mystery of Heart Disease in South Asians

Ashish Dua was 90 minutes into his workout when he felt a sudden tightness in his chest. After a few minutes of trying some light stretching — to no avail — he reached out to the gym staff, who rushed him to the hospital. In the taxi, Dua, 36 at the time, quickly developed cold sweats and felt like he couldn’t breathe. “I was nosediving,” he said. “I was thinking, ‘how could I get hurt?’ I work out five times a week and I eat clean.”

Although doctors hurried him onto the operating table, even they were skeptical that he would make it and put his chances of survival at 3% to 5%. Dua’s left artery was completely blocked, and his right artery was 95% blocked. After six months, when doctors brought him back to the hospital for a CT scan, they found that the cause of the heart attack was his dilated left main artery. Nobody knew how that had happened. 

Dua’s story isn’t unfamiliar. Despite comprising 25% of the world’s population, South Asians make up 60% of heart disease patients globally. They are also four times more likely to develop heart disease and 40% more likely to die from a heart attack than the general population, and at an earlier age than the average patient. 

The numbers are shocking, but they aren’t new — studies from as far back as 1959 reveal South Asian vulnerability to heart disease. So why do South Asians experience heart issues at much higher rates? And why, after six decades of research and data, are we still struggling to answer that question?