A major study comparing heart disease risk factors across different racial and ethnic groups in America found that South Asian adults develop dangerous health conditions like high blood pressure and prediabetes at younger ages than White, Chinese, and Hispanic people. Researchers tracked thousands of middle-aged adults over many years and discovered that by age 45, South Asians already showed higher rates of these risk factors. The study suggests that South Asian communities may need earlier health screenings and prevention strategies to catch and manage these conditions before they become serious heart problems.

The Quick Take

  • What they studied: Whether South Asian adults in America develop heart disease risk factors (like high blood pressure and diabetes) earlier in life compared to other racial and ethnic groups
  • Who participated: Adults aged 45-55 years from two large health studies: one focused on South Asians living in America (MASALA) and one tracking multiple ethnic groups (MESA). Participants were followed over 8-18 years with regular health check-ups.
  • Key finding: At age 45, South Asian adults had the highest rates of prediabetes and high blood pressure compared to White, Chinese, and Hispanic adults. By age 55, South Asians had the highest risk of developing diabetes. These differences were significant and consistent across the study period.
  • What it means for you: If you’re South Asian, you may benefit from earlier and more frequent heart health screenings starting in your 40s. This doesn’t mean you will definitely develop heart disease, but it suggests your doctor should monitor your blood pressure, blood sugar, and cholesterol more closely at a younger age than might be recommended for other groups.

The Research Details

Researchers combined information from two long-term health studies that tracked thousands of adults over many years. They looked at health records from 2000-2018, focusing on people who were between 45-55 years old. For each racial and ethnic group, they measured how many people had high blood pressure, prediabetes, diabetes, and unhealthy cholesterol levels at ages 45 and 55. They also tracked lifestyle factors like exercise and diet quality to see how these changed as people got older.

This approach is powerful because it follows the same people over time, allowing researchers to see how health conditions develop and change. By comparing South Asian adults to White, Chinese, Black, and Hispanic adults, the study could identify whether certain groups face higher risks at younger ages.

The researchers used statistical methods to account for differences between groups and to estimate what the risk would be at specific ages, even if not everyone was examined at exactly the same time.

Following people over many years (rather than just taking a snapshot at one moment) helps researchers understand when health problems typically start developing. This is especially important for heart disease prevention because catching risk factors early—before they become serious—gives people more time to make lifestyle changes or take medications that can prevent heart attacks and strokes.

This study is strong because it used two well-established, large health studies with detailed medical records and regular check-ups. The researchers had access to actual test results (blood pressure readings, blood sugar levels) rather than relying on people’s memories. The study included thousands of participants followed over many years, which makes the findings more reliable. However, the study is observational, meaning it shows that South Asians have higher risk factors but doesn’t prove why this happens. The findings apply to South Asians living in America and may not reflect those in other countries.

What the Results Show

At age 45, South Asian adults showed concerning patterns compared to other groups. They had the highest rates of prediabetes (a condition where blood sugar is higher than normal but not yet diabetic) and high blood pressure. For men specifically, South Asian men had higher rates of unhealthy cholesterol levels than White, Chinese, and Black men. South Asian women also had higher cholesterol problems than Chinese and Black women.

By age 55, the differences became even more pronounced. South Asian adults had the highest estimated risk of developing diabetes among all racial and ethnic groups studied. This suggests that the health gap doesn’t just stay the same—it actually widens as people age.

Interestingly, as all groups aged from 45 to 55, their diet quality improved and more people exercised regularly. However, this positive trend happened across all racial and ethnic groups, so it didn’t explain why South Asians still had higher risk factors.

The study found these patterns were consistent for both men and women, though sometimes the differences were more pronounced in one gender than the other.

The research showed that health risk factors increased in everyone as they got older—this is normal and expected. However, South Asian adults started from a higher baseline at age 45, meaning they had more risk factors to begin with. The study also found that lifestyle improvements (better diet and more exercise) happened across all groups, suggesting that these positive changes alone weren’t enough to explain the differences in heart disease risk factors between South Asians and other groups. This hints that there may be genetic, metabolic, or other biological factors specific to South Asian populations that contribute to earlier development of these conditions.

Previous research has shown that South Asians have higher rates of heart disease and diabetes compared to other groups, but this study adds important new information: these differences start appearing earlier in life than previously thought. Most earlier studies focused on older adults or didn’t directly compare South Asians to other groups in the same study. This research fills that gap by showing that the health disadvantage for South Asians begins in the mid-40s, not later in life. This finding aligns with what doctors have observed in clinical practice but now has strong scientific evidence behind it.

The study only included South Asians living in the United States, so the findings may not apply to South Asians in other countries or those who recently immigrated. The studies were conducted in specific geographic areas, which might not represent all South Asians in America. The research shows that South Asians have higher risk factors but doesn’t explain why—it could be due to genetics, lifestyle differences not measured in the study, access to healthcare, or other factors. Additionally, the studies didn’t include very young adults or very elderly people, so we don’t know if these patterns start even earlier or continue into very old age.

The Bottom Line

South Asian adults should discuss early heart disease screening with their doctor, ideally starting in their 40s rather than waiting until age 50 or later. This includes regular blood pressure checks, blood sugar testing, and cholesterol screening. If you’re South Asian and have a family history of diabetes or heart disease, screening should start even earlier. Lifestyle changes like regular exercise, a healthy diet, and maintaining a healthy weight are important for everyone but may be especially critical for South Asian adults given the earlier onset of risk factors. These recommendations have moderate to strong evidence support from this and related research.

This research is most relevant for South Asian adults in their 40s and 50s, their families, and their healthcare providers. If you’re South Asian and approaching or in your 40s, this information suggests you should be more proactive about heart health monitoring. Healthcare providers should consider more aggressive screening and prevention strategies for South Asian patients starting at younger ages. Family members of South Asians with heart disease or diabetes should also pay attention, as genetics may play a role. This doesn’t apply as directly to people of other racial and ethnic backgrounds, though everyone benefits from heart health awareness.

You won’t see immediate changes from screening or lifestyle modifications, but research shows that managing blood pressure and blood sugar in your 40s can prevent or delay diabetes and heart disease by years or even decades. If you start making changes now, you might see improvements in blood pressure and weight within weeks to months. However, the real benefit—preventing a heart attack or stroke—takes years to become apparent. Think of it as an investment in your future health.

Want to Apply This Research?

  • If you’re South Asian and over 40, track your blood pressure weekly and blood sugar levels if prediabetic. Log these readings in your health app along with the date. Set a reminder to check these metrics at the same time each week for consistency. Share these trends with your doctor at regular visits.
  • Set a specific goal like ‘Exercise 150 minutes per week’ or ‘Check blood pressure every Sunday morning.’ Use the app to log each exercise session and blood pressure reading. Create reminders for doctor appointments and medication refills. Track dietary choices to identify patterns that affect your blood sugar and blood pressure.
  • Create a dashboard showing your blood pressure and blood sugar trends over months. Set target ranges with your doctor and get alerts if readings go outside these ranges. Schedule quarterly reviews to assess progress. If you’re on medications, track adherence. Share monthly summaries with your healthcare provider to adjust treatment plans as needed.

This research shows associations between South Asian ethnicity and earlier development of heart disease risk factors, but it does not diagnose or predict individual risk. If you’re South Asian or have concerns about heart disease risk, consult with your healthcare provider about appropriate screening and prevention strategies for your specific situation. This information is educational and should not replace professional medical advice. Always discuss any changes to your health routine, diet, or exercise with your doctor, especially if you have existing health conditions or take medications.