New research published in Hypertension, an American Heart Association journal, has revealed significant differences in how South Asian and East Asian adults living in the United Kingdom develop high blood pressure over their lifetimes. These findings could help shape more personalized approaches to cardiovascular care for Asian populations, which are often grouped together in medical research despite their distinct health risks.
Key Differences in Blood Pressure Trajectories
Researchers analyzed health records from over 3,400 adults in the UK Biobank who self-identified as South Asian or East Asian. They tracked participants’ blood pressure trends over time and linked them to their risk of heart disease, strokes, and other cardiovascular events.
The study found that:
- South Asian adults experience earlier and faster increases in blood pressure compared to East Asian adults. At age 30, the projected systolic blood pressure for South Asian men was 124.9 mmHg, compared to 120.7 mmHg in East Asian men. For women, the difference was 107.4 mmHg vs. 105.7 mmHg.
- South Asian men were projected to reach high blood pressure (130 mmHg or higher) 10 years earlier than East Asian men (at age 36 vs. 46). South Asian women reached this threshold seven years earlier than East Asian women (at age 45 vs. 52).
- The combined projection showed that South Asians, on average, reached high blood pressure at age 40, while East Asians did not reach this level until age 49—a nine-year difference.
These findings suggest that South Asian individuals develop high blood pressure earlier in life, increasing their lifetime risk of heart disease.
The Impact on Cardiovascular Disease Risk and High Blood
For South Asians, high blood pressure in early adulthood was strongly associated with a greater risk of heart disease and peripheral artery disease. In contrast, East Asian adults were more likely to experience cardiovascular risks from high blood pressure in midlife and older age, particularly stroke.
- In East Asians aged 65 and older, each increase in systolic blood pressure significantly raised the risk of stroke—a nearly fourfold increase per standard deviation.
- For South Asians, diastolic blood pressure in young adulthood was linked to a more than twofold higher risk of peripheral artery disease.
The study also found that South Asian adults were nearly twice as likely as East Asians to develop high blood pressure by age 40 and were more likely to require blood pressure medication three years earlier, at an average age of 53.7 vs. 56.9 years.
Why These Differences Matter for High Blood
These findings highlight the importance of looking beyond a one-size-fits-all approach to cardiovascular care. Historically, many studies have lumped all Asian populations together under a single category, which can mask critical differences in disease risk.
“High blood pressure and its management vary widely across racial and ethnic populations, and the frequently used ‘Asian’ category hides those differences,” said lead study author So Mi Jemma Cho, Ph.D., a postdoctoral fellow at Massachusetts General Hospital and the Broad Institute of MIT and Harvard.
Senior study author Pradeep Natarajan, M.D., M.M.Sc., of Harvard Medical School, emphasized the need for tailored prevention strategies: “Distinct age-related blood pressure patterns provide valuable insights to better manage cardiovascular risks and improve care for diverse populations.”
Moving Toward More Personalized Care
Cardiologists and researchers are calling for updated screening guidelines that consider these differences. South Asian adults may benefit from earlier and more frequent blood pressure screenings, while East Asian adults may need focused monitoring for stroke risk later in life.
Dr. Nilay S. Shah, M.D., M.P.H., FAHA, who was not involved in the study, echoed the importance of recognizing diversity within Asian populations: “The authors provide important evidence supporting that cardiovascular risk factors like hypertension are not uniformly experienced among the diverse communities frequently but inappropriately aggregated under the race label ‘Asian.'”
While the study was conducted in the U.K., its findings raise broader questions about how social and genetic factors contribute to cardiovascular risk among Asian populations worldwide. Researchers stress that more work is needed to understand the complex interplay of genetics, lifestyle, and healthcare access that shapes heart disease risk in different ethnic groups.
Ultimately, the study underscores a critical shift in how medical research and healthcare providers should approach cardiovascular care—by recognizing the unique risks faced by different Asian populations and ensuring that screening, prevention, and treatment strategies reflect these differences.
Reference: So Mi J. Cho, Sarah Urbut, Yunfeng Ruan, Aarushi Bhatnagar, Shriienidhie Ganesh, Whitney E. Hornsby, Romit Bhattacharya, Michael C. Honigberg, Stephen P. Juraschek, Eugene Yang, Daichi Shimbo, Pradeep Natarajan. East and South Asian-Specific Blood Pressure Trajectories and Cardiovascular Disease. Hypertension, 2025.
