South Asian adults in the United States develop risk factors for atherosclerotic cardiovascular disease by age 45 at higher rates than white, Black, Chinese, or Hispanic adults of the same age, according to a study published in the Journal of the American Heart Association. The analysis of data from two long-term health studies found these risk factors, including high blood pressure, prediabetes, and type 2 diabetes, appear earlier in this population, potentially leading to earlier onset of heart disease if not properly managed.
Researchers examined health data for 2,700 adults aged 45–55 from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA). The MASALA study, based at Northwestern University and University of California, San Francisco, collected initial health checkups for South Asian participants between 2010–2013 with follow-up exams in 2016–2018. These participants traced their ancestry to Bangladesh, India, Nepal, Pakistan, or Sri Lanka. Researchers compared this data to publicly available MESA data for white, Black, Hispanic, and Chinese adults collected between 2000–2002 with follow-ups through 2016–2018.
The study revealed significant disparities in heart disease risk factors. At age 45, South Asian men had nearly eight times higher prevalence of prediabetes (30.7%) compared to white men (3.9%), and South Asian women had about three times higher prevalence (17.6%) compared to white women (5.7%). South Asian men also showed significantly greater prevalence of high blood pressure (25.5%) compared to white (18.4%), Chinese (6.6%), and Hispanic men (10.1%), and higher rates of dyslipidemia compared to Black men (78.2% vs. 60.6%). By age 55, both South Asian men and women were at least twice as likely to develop type 2 diabetes compared to white adults of the same age.
These findings are particularly notable because South Asian adults demonstrated healthier lifestyle behaviors overall. They had the best quality diet, lower alcohol use (defined as drinking one or more alcoholic drinks per week), and comparable exercise habits to other groups. The lifestyle measures included several components of the American Heart Association's Life's Essential 8, though researchers noted limitations including potential inaccuracies in self-reported behaviors and the higher educational and socioeconomic status of study participants.
Senior study author Namratha Kandula, M.D., M.P.H., a professor at Northwestern University's Feinberg School of Medicine and co-founder of the MASALA study, emphasized the implications for clinical practice. "The earlier accumulation of health conditions that increase the chance of heart disease among U.S. South Asian adults signals the need for earlier screening, tailored prevention and prompt risk-factor management," she said. This aligns with a 2023 scientific statement from the American Heart Association that reported South Asian adults face disproportionately high risk for ASCVD and recommended dietary modifications to help reduce this elevated risk.
For business and technology leaders focused on healthcare innovation and workforce health, this research highlights important demographic considerations in employee wellness programs and healthcare technology development. The findings suggest that one-size-fits-all approaches to cardiovascular screening and prevention may be inadequate for diverse populations. Companies with significant South Asian employees may need to consider earlier screening protocols and culturally tailored health interventions. The study also underscores the importance of continued research into genetic, environmental, and lifestyle factors contributing to these health disparities, which could inform future healthcare technologies and preventive strategies.
The research indicates that identifying risk factors early can lead to more effective prevention and treatment strategies for South Asian adults in the U.S., potentially reducing their risk for heart disease. However, the study's limitations include potential inaccuracies in self-reported behaviors, the gap between baseline exams in the two studies, and limited generalizability beyond the studied populations. The long-term data illustrates how cardiovascular disease risk factors appear earlier among South Asian adults compared to peers in other population groups, creating both a public health challenge and an opportunity for targeted intervention.
