Coronary Artery Disease

Coronary artery disease (CAD) results when cholesterol builds up within the arteries of the heart. South Asians are at an increased risk of developing CAD.


Blocked arteries can cause heart attacks and if untreated can result in weakening of the heart muscle. Look out for heart attack warning signs: chest pain, shortness of breath, fatigue, jaw/neck/arm pain.

How is CAD Diagnosed?

Recent studies suggest that people with a South Asian background should begin screening at age 18. Screening includes the following:

  • Screening for hypertension, diabetes and metabolic disorders
  • Blood tests to evaluate:
    • Lipids/genetic markers (i.e: lipid panel, Lipoprotein a [Lp(a)], LDL IIIa, LDL IVb, HDL-2b subtypes)
    • Inflammatory markers (i.e: CRP, fibrinogen)
  • Without symptoms: Cardiac calcium scoring, CT angiogram
  • With symptoms: EKG, Cardiac stress test, Coronary angiogram

What Are the Signs & Symptoms of CAD?

Some may not feel any symptoms until their first heart attack, but common symptoms to pay attention to include:

  • Chest pain / discomfort
  • Shortness of breath
  • Nausea
  • Fatigue and inability to finish activities of daily living (grooming, dressing, chores) without stopping for breaks several times

What Are the Risk Factors of Developing of CAD?

  • Poor diet
  • Lack of physical activity
  • High blood pressure
  • Diabetes
  • High cholesterol (specifically, high apoB/apoA1 ratio on lab test)
  • Obesity (BMI 23 or higher for South Asians)
  • Smoking and tobacco use
  • Alcohol use
  • Family history
  • Stress

Prevention & Treatment

  • Lifestyle modifications alone are not enough to prevent CAD
    • Low fat, low carb, high fiber diet (i.e: less rice/bread, more fruits and vegetables)
    • Lose weight
    • Exercise at least 150 minutes per week
    • Manage stress with relaxation techniques
  • Medications, in addition to lifestyle modifications, are necessary to:
    • Control blood pressure
    • Lower the heart rate
    • Keep blood thin
    • Discuss the evidence surrounding your increased risk, given your South
    • Asian background with your doctor.
  • Procedures may be necessary in serious cases, such as in the event of a heart attack. These include:
    • Coronary angiogram and stent placement
    • Coronary artery bypass surgery

Consult your doctor before using any alternative therapies. Sometimes, even “natural” remedies can interact with your prescribed medications. DO NOT stop your medications without discussing with your doctor first!



  1. American College of Cardiology
  2. American Heart Association
  3. El Camino South Asian Heart Center