Heart disease risk factors appeared at younger age among South Asian adults in the U.S.

(Press-News.org) Research Highlights:

South Asian adults begin developing risk factors for heart disease earlier—by their mid-40s—according to an analysis of data from two long-running health studies in the United States. Despite healthier lifestyle/behaviors, such as higher diet quality, lower alcohol use and comparable exercise levels, South Asian adults were more likely to have high blood pressure and/or prediabetes or type 2 diabetes compared to white, Chinese and Hispanics adults of the same age. At age 45, South Asian men were nearly 8 times more likely and South Asian women about three times more likely to have prediabetes than their white peers. Embargoed until 4 a.m. CT/5 a.m. ET Wednesday, Feb. 11, 2026

DALLAS, Feb. 11, 2026 — South Asian adults in the U. S. were more likely to have risk factors for atherosclerotic cardiovascular disease (ASCVD) by age 45 when compared to white, Black, Chinese or Hispanic adults in the same age group, according to a study published today in the Journal of the American Heart Association, an open access, peer-reviewed journal of the American Heart Association. These ASCVD risk factors can lead to earlier heart disease if they are not treated and managed.

To understand why, researchers analyzed health data for 2,700 adults, ages 45–55 from two national studies in the U.S. The health data examined were from two long-term studies that followed a diverse group of adults from different regions in the U.S.: 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 in Chicago, IL and University of California, San Francisco, collected initial health checkups for South Asian participants, who traced their ancestry to Bangladesh, India, Nepal, Pakistan, or Sri Lanka, between 2010–2013 and with follow-up health exams in 2016–2018. Researchers compared the health data of participants in MASALA to publicly available MESA data for white, Black, Hispanic and Chinese adults of the same age. MESA began initial health checkups in 2000–2002 and conducted follow-ups every two years, with the most recent exam visits in 2016–2018.

The analysis examined health conditions that raise heart disease risk—such as high blood pressure, prediabetes and type 2 diabetes—as well as lifestyle behaviors, including diet, tobacco, alcohol use, physical activity and sex differences.

The lifestyle measures collected during office visits, several components that are part of the American Heart Association’s Life’s Essential 8, included determining diet quality, physical activity and alcohol consumption based on self-reported information. Alcohol use was defined as drinking one or more alcoholic drinks per week.

Key findings from the study:

The difference in heart disease risks between South Asians and other populations was largely driven by prediabetes, diabetes and high blood pressure. South Asian men had a higher prevalence of prediabetes at age 45 (30.7%) when compared to peers in other ethnic groups (white: 3.9%, Chinese: 12.6%, Black: 10.4%, Hispanic: 10.5%). South Asian men had a significantly greater prevalence of high blood pressure (25.5%) compared to white (18.4%), Chinese (6.6%) and Hispanic men (10.1%), and a significantly greater prevalence of high cholesterol and/or triglycerides (dyslipidemia) compared to Black men (South Asian men: 78.2% vs. Black men: 60.6%). Similarly, South Asian women had almost two times higher prevalence of prediabetes at age 45 (17.6%) compared to peers in other population groups (white women: 5.7%, Chinese women: 8.2%, Black women: 9.0%, Hispanic women: 5.1%). At age 55, both South Asian men and women were at least two times more likely to develop type 2 diabetes when compared to white adults at the same age. Despite having higher rates of heart disease risk factors, South Asian adults also had the best quality diet, lower use of alcohol and comparable exercise habits. Senior study author Namratha Kandula, M.D., M.P.H., a professor of medicine in internal medicine and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago and a co-founder of the MASALA study, said, “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. If you are a South Asian adult, maintain a healthy lifestyle and get screened sooner — check blood pressure, glucose/A1c levels and cholesterol in early adulthood rather than waiting for symptoms.”

A 2023 scientific statement from the American Heart Association likewise reported that South Asian adults face disproportionately high risk for ASCVD caused by the buildup of plaque within the arteries. To mitigate this, it advises some dietary modifications—such as increasing whole‑grain intake, selecting cooking oils lower in saturated fat and avoiding deep‑fried preparation methods—to help reduce this elevated risk.

The long-term data analyzed in this study illustrate how health factors that contribute to cardiovascular disease, like high blood pressure; elevated levels of cholesterol and/or triglycerides (dyslipidemia); and prediabetes, appeared earlier among South Asian adults when compared to peers in other population groups. Identifying risk factors early can lead to early prevention and treatment strategies for South Asian adults in the U.S. and reduce their risk for heart disease.  

The study has several limitations including the use of self-reported behaviors can be inaccurate because individuals may forget details or give answers they think may sound more desirable. Also, both the MASALA and MESA studies relied on participants following up, and these individuals were most often participants with higher educational and socioeconomic status. In addition, there may be limited generalizability beyond the populations studied in MASALA and MESA. Lastly, the MASALA and MESA had a gap of a decade between initial baseline exams – the MASALA baseline exam was initially conducted in 2010-2013, while the initial baseline exam for participants in MESA took place between 2000 and 2002.

Co-authors, disclosures and funding sources are listed in the manuscript.

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Additional Resources:

Multimedia is available on the right column of release link. American Heart Association video: South Asians and heart disease: What to know American Heart Association guideline: Guideline for the Prevention, Detection, Evaluation and Management of High Blood Pressure in Adults: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines (Aug. 2025) American Heart Association news release: Heart & stroke risks vary among Asian American, Native Hawaiian & Pacific Islander adults (March 2025) American Heart Association news release: High BP may develop at different ages and paces in East & South Asian adults in the UK (Feb. 2025) American Heart Association scientific statement: Culture, diet, economic factors and more affect CVD risk among Asian Americans (May 2023) American Heart Association news release: Why are South Asians dying of heart disease? MASALA looks for answers (May 2023) American Heart Association news release: “One-size-fits-all” flawed for assessing cardiovascular disease risk among Asian Americans (May 2022) Follow American Heart Association/American Stroke Association news on X @HeartNews Follow news from the Journal of the American Heart Association @JAHA_AHA ###

About the American Heart Association

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