# Asia at the Epicenter of the Global Cardiometabolic Shift

## TL;DR

Cardiometabolic diseases are rising rapidly in Asia due to biological factors and weak health systems, requiring tailored prevention and treatment strategies.

## Contribution

Highlights how biological susceptibility and health-system limitations uniquely drive cardiometabolic disease in Asia.

## Key findings

- Metabolic risk in Asians emerges at lower BMI than in Western populations.
- Life-course prevention and improved primary care are critical for managing cardiometabolic conditions.
- Access to therapies and risk tools tailored for Asian populations is essential for progress.

## Abstract

Cardiometabolic disease has become the dominant noncommunicable health challenge of the 21st century, with its burden increasingly centered in Asia. Rising obesity, type 2 diabetes mellitus, hypertension, and dyslipidemia now account for more than one-third of cardiovascular mortality. This escalation reflects the interaction of biological susceptibility with rapid urbanization, digitalized food environments, physical inactivity, and persistent tobacco exposure. Health-system limitations, including low diagnosis rates, poor risk-factor control, and uneven access to essential therapies, further amplify vulnerability across South, East, and Southeast Asia. Environmental pressures such as air pollution and extreme heat compound these risks, while migrant data illustrate how biological predisposition is magnified in obesogenic settings. This review synthesizes evolving epidemiology, biological diversity, behavioral and environmental drivers, and health-system gaps shaping cardiometabolic risk across Asia. It also outlines policy and therapeutic strategies, including strengthened primary care, prevention-focused interventions, and emerging therapeutics needed to reduce cardiometabolic disease in the region.

•Cardiometabolic disease is increasing fastest in Asia due to biological vulnerability and health-system constraints.•Metabolic risk develops at lower BMI in Asian populations, limiting the use of Western risk thresholds.•Life-course prevention and stronger primary care are central to managing cardiometabolic multimorbidity.•Progress will depend on fair access to effective therapies and risk tools tailored to Asian populations.

Cardiometabolic disease is increasing fastest in Asia due to biological vulnerability and health-system constraints.

Metabolic risk develops at lower BMI in Asian populations, limiting the use of Western risk thresholds.

Life-course prevention and stronger primary care are central to managing cardiometabolic multimorbidity.

Progress will depend on fair access to effective therapies and risk tools tailored to Asian populations.