South Asian adults have naturally higher lipoprotein(a) levels, a blood fat that increases heart disease risk, with people from Bangladesh averaging 23 mg/dL compared to 17 mg/dL for those from Sri Lanka. According to Gram Research analysis of nearly 9,000 South Asians, this blood fat affects heart disease risk equally across all South Asian ethnic groups, meaning doctors don’t need different treatment approaches based on country of origin. Lifestyle factors like diet and exercise have only modest effects on lipoprotein(a) levels, suggesting genes play the dominant role.
Researchers studied over 8,900 South Asian adults from the United States and United Kingdom to understand a blood fat called lipoprotein(a), or Lp(a), that increases heart disease risk. According to Gram Research analysis, they found that South Asians have higher Lp(a) levels than other populations, with some variation between people from different South Asian countries. While diet, medications, and time living in the U.S. showed small connections to Lp(a) levels, the most important discovery was that Lp(a) affects heart disease risk equally across all South Asian groups. This research helps doctors better understand why South Asians face higher rates of heart problems.
Key Statistics
A 2026 analysis of 2,074 South Asian adults in America found median lipoprotein(a) levels of 23 mg/dL in people from Bangladesh, 22 mg/dL in those from India and Pakistan, and 17 mg/dL in those from Sri Lanka, showing significant variation by country of origin.
Among 6,845 South Asian adults in the UK Biobank, lipoprotein(a) increased heart disease risk equally across all South Asian ethnic groups, with no significant differences by country of origin or ethnicity.
In the MASALA study of South Asian Americans, vegetarian diet, statin use, postmenopausal status, and fewer years in the United States showed only modest associations with higher lipoprotein(a) levels, indicating that lifestyle factors have limited influence on this blood fat.
The Quick Take
- What they studied: How a blood fat called lipoprotein(a) varies among different South Asian groups and whether it increases heart disease risk differently depending on which South Asian country someone’s family comes from.
- Who participated: About 2,074 South Asian adults living in America (average age 57) and 6,845 South Asian adults in the United Kingdom (average age 55). Participants were from Bangladesh, India, Pakistan, and Sri Lanka.
- Key finding: South Asians have higher lipoprotein(a) levels than other populations, with people from Bangladesh having the highest levels (23 mg/dL) and people from Sri Lanka having the lowest (17 mg/dL). However, this blood fat increases heart disease risk the same way across all South Asian groups.
- What it means for you: If you’re South Asian, your doctor should check your lipoprotein(a) levels because they’re naturally higher in your population. The good news is that your risk of heart disease from this blood fat doesn’t depend on which South Asian country your family comes from. Talk to your doctor about managing this risk factor through diet, exercise, and possibly medication.
The Research Details
Researchers combined information from two large studies: MASALA, which follows South Asian adults living in America, and the UK Biobank, which tracks health in people living in the United Kingdom. They measured lipoprotein(a) levels in blood samples and looked at how these levels differed based on where participants were born (Bangladesh, India, Pakistan, or Sri Lanka). They also collected information about diet, exercise, medications, and whether participants had heart attacks or strokes during the study period.
The researchers used statistical methods to find connections between lifestyle factors and lipoprotein(a) levels, and to see whether high lipoprotein(a) predicted heart disease differently depending on someone’s South Asian background. This approach allowed them to study a large, diverse group of South Asians and get reliable answers about whether this blood fat affects different South Asian groups in different ways.
By combining data from two countries and multiple South Asian ethnic groups, the study provides a more complete picture than previous research that often lumped all South Asians together. This helps doctors understand whether they need different treatment approaches for different South Asian populations.
Previous research showed that South Asians have higher rates of heart disease compared to other populations, but scientists didn’t fully understand why. This study focuses on lipoprotein(a), a blood fat that’s partly controlled by genes and partly by lifestyle. By examining whether lipoprotein(a) levels and their effects on heart disease vary among different South Asian groups, researchers can help doctors provide more personalized care. Understanding these differences is important because it affects how doctors screen for and treat heart disease risk in South Asian communities.
This study is strong because it includes a large number of participants (over 8,900 people) from two different countries and multiple South Asian ethnic groups. The researchers measured actual blood samples rather than relying on self-reported information. They followed participants over time to see who actually developed heart disease, which is more reliable than just asking about risk factors. However, the study is observational, meaning researchers watched what happened naturally rather than randomly assigning people to different treatments, so they can identify connections but not prove cause-and-effect. The modest associations found between lifestyle factors and lipoprotein(a) suggest that other factors not measured in this study may also play important roles.
What the Results Show
Among South Asian adults in America, the median lipoprotein(a) level was 20.7 mg/dL, which is higher than typical levels in European populations. However, there was meaningful variation by country of origin. People from Bangladesh had the highest median level at 23 mg/dL, followed by people from India and Pakistan at 22 and 19 mg/dL respectively, while people from Sri Lanka had the lowest at 17 mg/dL. These differences were statistically significant, meaning they’re unlikely to be due to chance.
When researchers looked at lifestyle factors, they found several small connections to lipoprotein(a) levels. People who followed a vegetarian diet, took cholesterol-lowering medications called statins, were past menopause, or had lived fewer years in the United States tended to have slightly higher lipoprotein(a) levels. Interestingly, people who drank alcohol had slightly lower lipoprotein(a) levels. However, all these connections were very modest, suggesting that lifestyle factors explain only a small part of why lipoprotein(a) levels vary.
The most important finding came from the UK study: lipoprotein(a) increased heart disease risk equally across all South Asian groups, regardless of country of origin. This means that if you’re South Asian, your lipoprotein(a) level predicts your heart disease risk the same way it does for other South Asians, whether your family comes from Bangladesh, India, Pakistan, or Sri Lanka. This suggests that doctors don’t need different treatment strategies for different South Asian ethnic groups when managing lipoprotein(a) risk.
The study found that among Indian-origin participants in America, lipoprotein(a) levels also varied by the U.S. state where they lived, suggesting that environmental or lifestyle factors in different regions may influence these levels. The fact that vegetarian diet was associated with higher lipoprotein(a) was unexpected, since vegetarian diets are generally considered heart-healthy. This finding suggests that lipoprotein(a) is largely determined by genes rather than diet, which explains why lifestyle changes had only modest effects. The observation that people who had lived fewer years in the United States had higher lipoprotein(a) levels hints that immigration or acculturation may influence this blood fat, though the reasons aren’t clear from this study.
Previous research established that South Asians have higher lipoprotein(a) levels than European populations and that this contributes to their higher heart disease rates. This study builds on that knowledge by showing that variation exists even within South Asian populations. Earlier studies often treated all South Asians as one group, but this research reveals that country of origin matters for lipoprotein(a) levels. However, the finding that lipoprotein(a) affects heart disease risk equally across South Asian subgroups is reassuring and suggests that the genetic basis of lipoprotein(a) is similar across South Asian populations, even though the average levels differ.
The study is observational, meaning researchers observed what happened naturally rather than randomly assigning people to different diets or treatments, so they can’t prove that vegetarian diet actually causes higher lipoprotein(a). The associations between lifestyle factors and lipoprotein(a) were very modest, suggesting that unmeasured factors may be more important. The study measured lipoprotein(a) at only one point in time, so researchers couldn’t track how levels change over years. The UK Biobank participants were somewhat older and may not represent all South Asians. Finally, the study didn’t examine genetic factors in detail, even though lipoprotein(a) is primarily determined by genes, so future research should investigate which specific genes differ among South Asian groups.
The Bottom Line
If you’re South Asian, ask your doctor to check your lipoprotein(a) level as part of your heart disease risk assessment, since your population naturally has higher levels. Work with your doctor to manage other heart disease risk factors like high blood pressure, high cholesterol, smoking, and lack of exercise, since these are modifiable. If your lipoprotein(a) is very high, discuss with your doctor whether you need additional medications or more aggressive lifestyle changes. Don’t assume that becoming vegetarian will lower your lipoprotein(a), since diet appears to have minimal effect on this particular blood fat. These recommendations have moderate confidence because the study is large and well-designed, though it’s observational rather than experimental.
This research is most relevant for South Asian adults and their doctors, particularly those with family history of heart disease. It’s also important for public health officials and healthcare systems serving South Asian communities. People from other ethnic backgrounds should know that this research doesn’t necessarily apply to them, since lipoprotein(a) levels and their effects may differ. However, the general principle that lipoprotein(a) is an important heart disease risk factor applies to everyone.
Lipoprotein(a) levels are largely determined by genes and don’t change quickly. If you make lifestyle changes or start medications, it may take 3 to 6 months to see any effect on lipoprotein(a) levels, and the changes are typically modest. However, managing other heart disease risk factors like blood pressure and cholesterol can reduce your overall heart disease risk within weeks to months. If you’re at high risk, your doctor may recommend more aggressive treatment rather than waiting to see if lifestyle changes alone work.
Frequently Asked Questions
Why do South Asians have higher lipoprotein(a) levels than other groups?
Lipoprotein(a) is primarily determined by genes inherited from parents, and South Asian populations carry genetic variants that result in higher average levels. This 2026 study found median levels of 20.7 mg/dL in South Asians versus lower levels in European populations, with variation even among different South Asian countries.
Can I lower my lipoprotein(a) by changing my diet or exercise?
Diet and exercise have only modest effects on lipoprotein(a) since it’s mainly genetic. This study found that vegetarian diet, alcohol consumption, and years living in the U.S. showed small connections to lipoprotein(a) levels, but these explained very little of the variation. Talk to your doctor about medications if your level is high.
Does lipoprotein(a) affect heart disease risk differently depending on my South Asian background?
No. This research of 6,845 South Asians found that lipoprotein(a) increases heart disease risk equally across all South Asian ethnic groups, regardless of whether you’re from Bangladesh, India, Pakistan, or Sri Lanka. Your doctor can use the same risk assessment approach for all South Asians.
How often should I get my lipoprotein(a) checked if I’m South Asian?
Since lipoprotein(a) is largely genetic and doesn’t change much over time, one measurement is usually sufficient for risk assessment. However, discuss with your doctor whether annual screening makes sense based on your family history and other heart disease risk factors. Most guidelines recommend checking it at least once.
What should I do if my lipoprotein(a) is high?
Work with your doctor to manage other modifiable heart disease risk factors like blood pressure, cholesterol, smoking, and exercise. Your doctor may recommend medications if your lipoprotein(a) is very high combined with other risk factors. Regular monitoring and preventive care are important since lipoprotein(a) itself doesn’t respond well to lifestyle changes.
Want to Apply This Research?
- Log your lipoprotein(a) test results annually and track the date of your last check-up. Set a reminder to discuss lipoprotein(a) with your doctor at your next visit, especially if you haven’t had it measured in the past year.
- Use the app to track heart disease risk factors you can control: blood pressure readings, exercise minutes per week, and diet quality. While lipoprotein(a) itself won’t change much with lifestyle changes, managing these other factors will reduce your overall heart disease risk.
- Create a yearly health check-in reminder to review your lipoprotein(a) level, blood pressure, cholesterol, and blood sugar with your doctor. Track any medications you’re taking and note whether your doctor recommends changes based on your lipoprotein(a) results. Over time, this creates a record showing whether your overall heart disease risk is improving.
This research provides important information about lipoprotein(a) in South Asian populations, but it is not a substitute for personalized medical advice. Lipoprotein(a) levels are just one factor in heart disease risk. If you are South Asian or have concerns about your heart disease risk, consult with your healthcare provider about whether lipoprotein(a) testing is appropriate for you and what steps you should take based on your individual health profile. Do not make changes to medications or lifestyle based solely on this research without discussing with your doctor. This article summarizes research findings and does not constitute medical diagnosis or treatment recommendations.
This research translation is published by Gram Research, the science division of Gram, an AI-powered nutrition tracking app.