By Adelyn Emil
The United States healthcare system continues to overlook the urgent need to improve South Asian cardiovascular disease (CVD) outcomes, and it shows.
CVD is the number one cause of death in the United States. A 2024 analysis in JAMA Network Open found that the burden of CVD among South Asians is 9.3% compared to 6.3% among whites. Despite clear evidence of elevated risk factors and genetic predispositions among the former group, the healthcare system has made little effort to address these disparities. Ignoring these issues harms South Asians and affects the broader population, especially given the rapid growth of the Asian American community, which has increased from 11.9 million to 24.8 million people over the past few decades, according to a 2025 Pew Research Center report. This trend is also visible in the Pacific Northwest. Data USA estimates that Seattle is home to roughly 126,000 non-Hispanic Asian residents as of 2023, and regional reports from Greater Seattle Partners show that the Indian diaspora is one of the area’s fastest-growing immigrant communities, contributing to a 47% increase in the region’s immigrant population between 2000 and 2020.
The importance of adjusting screening factors
While CVD rates have declined among whites over the past 30 years, Asian Americans have seen a steady increase. Research summarized in Cureus in 2024 shows that Asian Americans, including South Asians, frequently develop hypertension at lower blood pressure levels and type II diabetes at lower HbA1c levels than other groups. As a result, standard screening practices often fail to detect disease early. Without early detection, many South Asian patients develop CVD at disproportionately younger ages, even when their test results appear “normal.” This gap in care is not coincidental. It stems from a deeper, systemic issue: a severe lack of South Asian representation in cardiovascular research.
A major reason screening guidelines have not been updated is the severe lack of South Asian-specific data. Asian Americans are frequently grouped together in health research despite major differences among subgroups. A 2025 systematic review in JACC: Asia analyzed more than one million participants across 310 cardiovascular trials and found that only 3.16% were of South Asian origin. Most came from a single study in Kerala, meaning fewer than 1.1% of participants lived outside South Asia. Given the distinct lifestyles, diets, and environments of South Asians in the United States, this lack of representation is alarming.
Changes through advocacy
Addressing these disparities requires advocacy. Increasing South Asian representation in CVD trials and strengthening data collection are essential steps toward understanding why this community faces such high disease burdens. With better data, companies can refine screening tools, and hospitals can adopt practices that reflect South Asian-specific risks. In Seattle, advocacy also means urging local research institutions—such as the University of Washington’s Cardiovascular Health Research Unit, UW Cardiology’s research programs, the Swedish Heart & Vascular Institute, and the Kaiser Permanente Washington Health Research Institute—to include more South Asian participants and to disaggregate Asian health data rather than treating Asians as a single group.
Engaging Seattle City Council and King County Council members to support health equity initiatives can further amplify these efforts. Community members can contribute by contacting representatives, supporting South Asian-focused research, and encouraging local health organizations to adopt specific screening guidelines. You might be thinking: Well, that’s great, but I don’t work in a field where I can make this type of impact. However, that isn’t true. You can help advocate for these changes regardless of your role in society. While public health researchers, policymakers, clinicians, and others may initiate change directly, community advocacy is what builds momentum and compels decision-makers to act.
Adelyn is an undergraduate student at the University of Washington School of Public Health.
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