A study published in the Journal of the American Heart Association found South Asian adults in the United States are more likely to develop risk factors for atherosclerotic cardiovascular disease by age 45 compared to white, Black, Chinese, or Hispanic adults of the same age. These risk factors, including high blood pressure, prediabetes, and type 2 diabetes, can lead to earlier heart disease if not treated and managed.
Researchers analyzed health data for 2,700 adults aged 45–55 from two long-term U.S. studies: the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study and the Multi-Ethnic Study of Atherosclerosis (MESA). The analysis compared health conditions that raise heart disease risk and lifestyle behaviors, including diet, tobacco and alcohol use, and physical activity.
Key findings showed the difference in heart disease risks was largely driven by prediabetes, diabetes, and high blood pressure. At age 45, South Asian men had a 30.7% prevalence of prediabetes, nearly eight times higher than their white peers (3.9%). South Asian women had a 17.6% prevalence, about three times higher than white women (5.7%). South Asian men also had significantly greater prevalence of high blood pressure (25.5%) compared to white (18.4%), Chinese (6.6%), and Hispanic men (10.1%).
By age 55, both South Asian men and women were at least two times more likely to develop type 2 diabetes compared to white adults at the same age. Despite these higher risk factor rates, South Asian adults had the best quality diet, lower alcohol use, and comparable exercise habits, based on self-reported information that included components of the American Heart Association's Life’s Essential 8.
Senior study author Namratha Kandula, M.D., M.P.H., a professor at Northwestern University's Feinberg School of Medicine and a co-founder of the MASALA study, emphasized the need for earlier screening and tailored prevention. "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," Kandula said.
The findings align with a 2023 scientific statement from the American Heart Association reporting South Asian adults face disproportionately high risk for ASCVD. That statement advised dietary modifications, such as increasing whole-grain intake and selecting cooking oils lower in saturated fat, to help reduce this elevated risk.
Identifying these risk factors early can lead to early prevention and treatment strategies for South Asian adults in the U.S. and reduce their heart disease risk. The study has limitations, including reliance on self-reported behaviors that can be inaccurate and potential limited generalizability beyond the studied populations. The full study is available in the Journal of the American Heart Association.
