Improving South Asian Heart Health Through Research

Donor Support for the MASALA Study Fuels Better Cardiovascular Care for All

Hitesh Patel, ’89 MBA, still remembers the shock when his father, not yet 60, underwent an emergency quadruple bypass and doctors discovered he had already suffered several silent heart attacks.

The memory stayed with him but resurfaced in August, he said, when he attended a documentary screening of The Brown Heart at the Museum of Contemporary Art in Chicago. At the screening, Namratha R. Kandula, MD, MPH, professor of Medicine and Preventive Medicine at Northwestern University Feinberg School of Medicine, delivered remarks on South Asians’ cardiovascular health that deeply resonated with Patel. Citing the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study she co-leads, Dr. Kandula shared that standard cardiovascular screening tools often miss risks common among South Asians.

“Many of us know stories of friends or loved ones who have been turned away from an ER because no one thought they could be having a heart attack,” Dr. Kandula told attendees. “Unfortunately, this is still common.”

Though South Asians comprise roughly a quarter of the world’s population—nearly 2 billion people—they experience 60 percent of global heart disease cases. Since heart disease is the No. 1 killer of men and women worldwide, studying the population most heavily impacted will help doctors better understand, prevent, and treat the disease for all. The MASALA Study, named for the cooking spice blend originating in South Asian countries, centers its research on individuals with roots in Bangladesh, India, Pakistan, Nepal, and Sri Lanka.

The study has revealed surprising findings that suggest the increased risk of heart disease in South Asians is complex, resulting from environmental, genetic, behavioral, and social factors that, if understood, could save lives. For one, the study has found that the standard range for coronary artery calcium (CAC) does not accurately reflect risk for South Asians, leading the team to develop more appropriate CAC thresholds for this population. CAC is measured through a CT scan that detects calcium buildup in the heart’s arteries and is an early indicator of heart disease. The study has also shown that high lipoprotein(a) (Lp[a]), a genetically inherited form of cholesterol that raises cardiovascular risk, is more common in South Asians than in other groups—yet isn’t routinely tested.

Patel, who grew up in Gujarat, India, and has lived in Chicago since 1983, described Dr. Kandula’s remarks and the documentary as “eye-opening.” He had already made significant changes in his early 30s after his father’s heart attack, limiting fats and salt in his diet. Now 65, he has leaned further into high-fiber foods and lentils, swapped sandwiches for hearty salads, and added regular physical training and swimming. Yet, despite Patel’s disciplined approach to diet and exercise, his CAC and Lp(a) remain elevated. “Even with everything I do, the tests still came back high,” he said.

“There’s a lot of value in the MASALA Study in continuing to figure out what’s causing this—biomarkers, structural differences, genetic factors—and whether anything can be done,” Patel said.

A Unique Window into Heart Risk

Launched in 2010 with support from the National Institutes of Health, MASALA is co-led by Dr. Kandula at Northwestern with colleagues at the University of California, San Francisco, and at New York University. Designed to close critical gaps in understanding South Asian cardiovascular health, the study’s insights have far-reaching implications, informing more precise prevention and treatment strategies well beyond South Asian populations.

The MASALA Study is the only long-term US study focused on South Asian heart health, following more than 2,300 participants. In addition to showing that standard CAC thresholds are different for people of South Asian background, the study also found that South Asians also have more fat stored around internal organs and lower muscle mass, which is correlated with diabetes and heart disease—even in people who are not overweight. As the first study to examine vegetarian diets common in this community, it has identified which types of vegetarian diets are protective and which increase risk, underscoring that avoiding red meat alone does not guarantee heart disease prevention.

Underrepresentation in research has led to this treatment gap, Dr. Kandula said, leading to high-risk patients being missed because current guidelines weren’t designed with data that represent them. “When data do not include you, the tools and guidelines doctors use may miss the risks you actually face,” she said.

Dr. Kandula’s work is personal. Her parents immigrated to the US from India, and she vividly remembers the call about her grandfather’s sudden death at age 56 from a heart attack, even though he “didn’t fit the profile” for a high-risk patient. That loss motivated her to pursue prevention-focused medicine and research that reflect the realities of South Asian health. As a parent, she screened her own children and found that both had elevated Lp(a), empowering her family to take action through healthy habits.

Developing the MASALA Study required years of building trust with community groups and faith leaders, returning results in clear language, and creating practical resources families and clinicians can use. But sustaining the study’s impact requires continued resources. The MASALA Study has received significant federal support over the years, but that funding diminished during the research funding freeze in 2025, Dr. Kandula said. Without additional investment, the study risks losing momentum on crucial questions about aging, sex differences in health, and new therapeutic targets using stored biological and genetic samples.

“Without continued resources, the MASALA Study could slow down or stop,” she said. “We would lose the chance to follow participants over time and investigate unanswered questions about health as people age and how heart disease may differ between South Asian women and men.”

This, Patel said, is what compelled him to give. He said he hopes the MASALA Study can continue to investigate South Asian heart health so that families like his can act sooner with the right information, the right screening, and the right care.

For more information about the MASALA Study, please contact Kathleen Praznowski at kathleen.praznowski@northwestern.edu or 312-503-0762.

This story was published in the March 2026 issue of The Philanthropist, a newsletter for supporters and friends of Northwestern University Feinberg School of Medicine. Read past issues here.