South Asian ethnicity and cardiovascular risk: the known, the unknown, and the paradox

South Asians (SAs), in their countries or after migration, are at high risk of coronary artery disease (CAD) and mortality compared to other ethnic groups. It has been shown that >90% of CAD global risk could be attributed to 9 modifiable risk factors (RFs) worldwide. However, these conventional RFs may not fully explain this high risk of CAD among SAs. Therefore, attention has been directed toward nonconventional RFs. In this narrative review, we evaluate the conventional and emerging cardiovascular RFs characterizing SAs. These factors may explain the high morbidity and mortality among SAs. Further prospective studies are urgently needed to set algorithms for the optimal management of these RFs in high-risk populations like SAs.