Ten years earlier
South Asians develop cardiovascular disease ten years earlier than Caucasians. The standard risk calculator was built on a 1948 Massachusetts cohort. Ask for ApoB. Ask for Lp(a). Ask early.
The Framingham risk calculator was built on a Massachusetts cohort starting in 1948. It systematically underestimates risk for South Asians, who develop cardiovascular disease about a decade earlier and often at lower body weights.
Ask for ApoB
A standard lipid panel reports LDL cholesterol — a useful but blunt number. ApoB counts every atherogenic particle, including the small dense LDL that South Asian dyslipidaemia favours. It is a better single predictor of risk.
Ask for Lp(a)
Lp(a) is mostly genetic. Diet and exercise barely move it. Most adults never get it measured even once — and a high Lp(a) adds independent cardiovascular risk on top of LDL.
The dyslipidaemia dialect
Lower HDL. Higher triglycerides. More abdominal fat at lower body weights. Knowing the pattern is half the playbook. The other half is starting in your thirties, not your fifties.