A new study published in Hypertension, an American Heart Association journal, reveals significant differences in how high blood pressure (hypertension) develops among East and South Asian adults living in the United Kingdom. The findings suggest that South Asian adults may experience elevated blood pressure nearly a decade earlier than their East Asian counterparts, highlighting the need for tailored cardiovascular risk assessments and interventions.
Key Findings
- South Asian adults in the UK were projected to experience higher blood pressure levels around nine years earlier than East Asian adults.
- The most significant disparities were found in young men (18-39 years) and middle-aged women (40-64 years).
- In East Asian adults, a rise in systolic blood pressure in midlife was linked to a 2.5 times higher risk of heart disease and a nearly fourfold increased risk of stroke.
- Even in older East Asian adults, high systolic blood pressure was a predictor for all types of stroke.
Understanding the Differences
Researchers analyzed the health records of more than 3,400 adults enrolled in the UK Biobank who self-identified as East Asian or South Asian. The study builds on previous findings that South Asian individuals living in Western countries face an elevated risk of atherosclerotic cardiovascular disease (ASCVD) compared to their European counterparts.
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“High blood pressure and its management vary widely across racial and ethnic groups. The broad label ‘Asian’ often obscures critical differences,” said lead study author Dr. So Mi Jemma Cho, a postdoctoral fellow at Massachusetts General Hospital and the Broad Institute of MIT and Harvard. “Since early-onset hypertension is a major contributor to premature heart disease, it’s crucial to recognize these differences to improve prevention strategies.”
Blood Pressure Trends and Risks
- By Age 30: The projected systolic blood pressure was 124.9 mmHg for South Asian men and 107.4 mmHg for South Asian women, compared to 120.7 mmHg for East Asian men and 105.7 mmHg for East Asian women.
- Age of Reaching High Blood Pressure (≥130 mmHg): South Asian men were projected to hit this threshold at age 36, while East Asian men reached it at age 46. Among women, South Asians reached this level at age 45, while East Asians did so at age 52.
- Lifetime Cardiovascular Risks: Early adulthood hypertension in South Asian adults was linked to higher lifetime heart disease risks, while in East Asians, midlife hypertension was associated with ASCVD and stroke risks.
Genetic and Social Factors at Play
The study also examined blood pressure patterns based on genetic ancestry rather than self-identified ethnicity, confirming similar trends. Lifestyle and social determinants of health, including smoking status, diet, and socioeconomic status, were also analyzed as contributing factors.
“These findings highlight the need for personalized health screenings and treatments for different Asian subpopulations,” said senior study author Dr. Pradeep Natarajan, associate professor at Harvard Medical School. “Distinct blood pressure patterns across age groups provide crucial insights for improving cardiovascular care in diverse populations.”
Study Details and Methodology
- The study drew from the UK Biobank, which tracks 503,325 adults aged 40-69 who were registered with the National Health Service (NHS).
- Of the 3,453 participants analyzed, 3,077 were South Asian and 376 were East Asian.
- South Asian adults in the study had higher blood pressure readings and were three times more likely to be on antihypertensive medications compared to East Asians.
- South Asian adults had higher body mass index (BMI) levels on average (27.6 kg/m² vs. 24.2 kg/m² for East Asians).
- By age 40, twice as many South Asian adults had hypertension compared to East Asians.
- South Asian adults began blood pressure medication three years earlier on average than East Asians (at age 53.7 vs. 56.9).
- Over a lifetime, South Asians had a fourfold greater incidence of heart disease due to blocked arteries (3.5 vs. 0.9 per 1,000 person-years).
Implications for Public Health
Experts emphasize that these findings reinforce the need for culturally and biologically tailored cardiovascular prevention strategies. Dr. Nilay S. Shah, an assistant professor at Northwestern University Feinberg School of Medicine, who was not involved in the study, commented:
“The results underscore that Asian populations are not a monolith. Differences in hypertension risks among Asian subgroups highlight the importance of considering both social and genetic factors when developing cardiovascular health strategies.”
Looking Ahead
While the study provides significant insights, researchers note limitations, including the potential for different environmental and healthcare factors outside the UK to influence results. Future research will need to explore how social determinants and genetic variations interplay to affect cardiovascular health outcomes in Asian populations globally.
With high blood pressure continuing to be a leading cause of heart disease and stroke, this research marks an important step toward precision medicine—ensuring the right interventions reach the right populations at the right time.
