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U.S. South Asians see heart risk by age 45: Study
The study, led by Northwestern Medicine and published on Feb. 11 in the Journal of the American Heart Association, found that by age 45 nearly one in three South Asian men had prediabetes, while one in four had hypertension.
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Malvika Choudhary - Mon, 16, Feb 2026
- 17:50 EST
- 15
Representative image / newsroom.heart.org
A new U.S. study finds that South Asian Americans experience high heart risk with elevated rates of prediabetes, diabetes and hypertension by age 45 despite healthier reported lifestyles than their peers.
The study, led by Northwestern Medicine and published on Feb. 11 in the Journal of the American Heart Association, found that by age 45 nearly one in three South Asian men had prediabetes, while one in four had hypertension. By age 55, South Asian men and women were at least twice as likely to develop diabetes as white adults.
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Researchers analyzed data from nearly 2,700 adults and found that participants with heritage from Bangladesh, India, Pakistan, Nepal and Sri Lanka had higher or comparable levels of cardiovascular risk factors than white, Black, Hispanic and Chinese adults, despite reporting healthier diets, lower alcohol use and comparable levels of physical activity.
“The mismatch between healthier lifestyle behaviors and clinical risk was surprising,” said Dr. Namratha Kandula, senior author of the study and a professor of general internal medicine and epidemiology at Northwestern University Feinberg School of Medicine. “This paradox tells us we’re missing something fundamental to what is driving this elevated risk among South Asians.”
Kandula said the findings point to a key window for prevention. “We’ve now identified a critical window in the 40s when risk is already high, but disease is still preventable,” she said.
The analysis combined data from two long-running cohort studies: the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study and the Multi-Ethnic Study of Atherosclerosis (MESA). Participants were between 45 and 55 years old at baseline and were followed for about a decade to assess changes in cardiovascular risk factors.
At age 45, South Asian men had a prediabetes prevalence of 31 percent, compared with 4 percent among white men, 10 percent among Black and Hispanic men, and 13 percent among Chinese men.
Hypertension affected 25 percent of South Asian men at the same age, higher than rates seen among white, Hispanic and Chinese men. South Asian women showed a similar pattern, with nearly one in five having prediabetes by age 45—roughly twice the rate observed in women from other groups.
Prior MASALA research has shown that South Asians tend to have higher levels of visceral fat even at lower body weights, a factor associated with heart disease.
EARLY LIFE FACTORS
Kandula said the findings suggest that risk factors may originate earlier in life citing data which showed most of the studied participants were immigrants whose childhood and early adulthood environments may differ.
“Early life nutrition, environment, stressors and activity patterns in childhood may increase cardiometabolic risks that show up by age 45,” she said.
The study’s authors said the findings support earlier and more proactive screening for South Asian adults. Kandula urged clinicians to assess blood sugar, blood pressure and other risk-enhancing factors before midlife and to offer culturally appropriate lifestyle counseling.
“Even if you eat well and exercise, you may still be at higher risk for diabetes and high blood pressure at younger ages,” Kandula said. “Early detection, treatment and control of these risk factors can prevent heart disease.”
The study is titled, “Prevalence and Trends in Cardiovascular Risk Factors Among Middle Aged South Asian Adults Compared with other Race and Ethnic Groups in the United States: A Longitudinal Analysis of Two Cohort Studies.”
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