Blood Pressure Rises Earlier & Faster in South Asians, New Study Finds – Implications for heart Health

London, UK – South Asian and East Asian adults in the UK exhibit distinct patterns in the development of high blood pressure, with South Asians experiencing earlier and more rapid increases, according to groundbreaking research published today in hypertension.The study, analyzing data from over 3,400 participants in the UK Biobank, highlights the critical need for tailored cardiovascular care within these diverse communities.

Researchers found that, on average, South Asian men reached a systolic blood pressure of 130 mmHg – classified as high blood pressure – a full decade earlier than thier East Asian counterparts (age 36 vs. 46). For women, the gap was seven years (45 vs. 52). Combined, South Asian adults reached this threshold at age 40, compared to 49 for East Asians – a nine-year difference.

“High blood pressure and its management varies widely across racial and ethnic populations,and the frequently used ‘Asian’ category hides those differences,” explained Dr. So mi Jemma Cho, lead author of the study and a postdoctoral fellow at Massachusetts General Hospital and the Broad Institute of MIT and harvard. “This is crucial considering that high blood pressure at a young age is a major contributor to premature heart disease risk.”

The study revealed differing links between blood pressure and cardiovascular disease risk based on ethnicity. Early adulthood high blood pressure in South Asian adults was strongly associated with increased lifetime cardiovascular disease risk, especially peripheral artery disease. In contrast, higher blood pressure in midlife was linked to increased risk of blocked arteries (ASCVD) and stroke in East Asian adults, with stroke risk remaining elevated even at ages 65 and older.

specifically, a standard deviation increase in midlife systolic blood pressure in East asian adults correlated with a nearly 2.5 times higher risk of ASCVD and a nearly fourfold greater risk of stroke.young adulthood diastolic blood pressure was linked to a 2.18 times higher risk of peripheral artery disease in South Asian adults.

These findings remained consistent even when analyzing genetic ancestry, reinforcing the significance of these ethnic-specific patterns.

“These findings demonstrate the need to tailor blood pressure screenings and treatment timing for different Asian subpopulations to advance personalized care and prevention strategies for historically understudied communities,” said senior author Dr. Pradeep Natarajan,an associate professor at Harvard

What are the key genetic and biological factors that contribute to the differing rates of age-related hypertension progression observed between South asian, East Asian, and White British adults in the UK?

Age-Related Hypertension Progression Varies Across East and south Asian Adults in the UK

Understanding Ethnic Disparities in Hypertension

Hypertension, or high blood pressure, is a notable public health concern globally, and its prevalence increases with age. However, research increasingly demonstrates that the progression of age-related hypertension isn’t uniform across all populations. Specifically,east and south Asian adults residing in the UK exhibit distinct patterns compared to their White British counterparts. This article delves into these variations, exploring the contributing factors, clinical implications, and potential management strategies.we’ll focus on blood pressure management and cardiovascular risk within these communities.

prevalence and Incidence Rates: A UK Outlook

while overall hypertension prevalence is rising in the UK, studies reveal notable differences based on ethnicity.

south Asian Adults: Demonstrate a higher prevalence of hypertension at younger ages compared to White British individuals. This suggests an earlier onset and potentially faster progression of the disease. Data from the Southall and Brent Revisited survey consistently highlights this trend.

East Asian Adults: While historically showing lower rates than White British populations, recent data indicates a concerning increase in hypertension among East asian adults in the UK, especially with aging.This shift necessitates further investigation.

Key Statistics (as of late 2024):

South Asian adults (ages 45-64): 35-40% hypertension prevalence.

East Asian adults (ages 45-64): 20-25% hypertension prevalence.

White british adults (ages 45-64): 25-30% hypertension prevalence.

These figures underscore the importance of ethnicity-specific screening and intervention programs. Early detection of hypertension is crucial.

Genetic and Biological factors Influencing Progression

Several genetic and biological factors contribute to the observed differences in hypertension progression:

Genetic Predisposition: Specific gene variants associated with blood pressure regulation are more prevalent in east and South Asian populations. These variants can influence sodium sensitivity, renin-angiotensin-aldosterone system (RAAS) activity, and vascular function.

Epigenetic Modifications: Lifestyle and environmental factors can induce epigenetic changes that alter gene expression, impacting blood pressure control. Dietary habits,stress levels,and socioeconomic factors play a role.

RAAS Activation: Studies suggest that the RAAS system is often more highly activated in South Asian individuals, contributing to increased blood pressure and cardiovascular risk. RAAS inhibitors are often a first-line treatment.

Endothelial Dysfunction: Impaired endothelial function, a key factor in vascular health, is frequently observed in these populations, potentially accelerating hypertension progression.

Lifestyle and Socioeconomic Determinants

Beyond genetics,lifestyle and socioeconomic factors significantly impact hypertension management and progression:

Dietary Patterns: Traditional South Asian and East Asian diets can be high in sodium and saturated fats,contributing to increased blood pressure. Dietary sodium intake is a major concern.

Physical activity: Lower levels of physical activity are often reported in these communities, increasing the risk of obesity and hypertension.

Stress and Mental Health: Socioeconomic disparities, discrimination, and acculturation stress can contribute to chronic stress, elevating blood pressure.

Healthcare Access: Barriers to healthcare access, including language barriers, cultural beliefs, and lack of awareness, can delay diagnosis and treatment. Improving healthcare access is paramount.

Vitamin D Deficiency: Prevalence of Vitamin D deficiency is higher in South Asian populations, potentially impacting blood pressure regulation.

Lower Blood Pressure Targets: Some guidelines suggest considering lower blood pressure targets for South Asian individuals due to their increased cardiovascular risk.

Personalized Medication Regimens: tailoring medication choices based on genetic predisposition and RAAS activity may improve treatment outcomes.

Culturally Sensitive Interventions: Developing culturally tailored lifestyle interventions that address dietary habits, physical activity levels, and stress management is essential.

Community-Based Screening Programs: Implementing targeted screening programs in South Asian and East asian communities can facilitate early detection and intervention.

Enhanced Patient Education: Providing clear and accessible details about hypertension, its risk factors, and management strategies is vital. Patient education materials should be available in multiple languages.

Case Study: Impact of a Community-Based intervention

A pilot study conducted in Southall, London, demonstrated the effectiveness of a community-based intervention program. The program included:

1. Regular blood pressure screenings at local community centers.

2.