Impact Story • Success Story
From Data to Guidelines: How the MASALA Study Advanced Earlier Detection of Heart Disease in South Asians
By
Nadia Islam, Ph.D.
(1)
,
et al.
All Authors and Affiliations
By
Nadia Islam, Ph.D.
(1)
,
Shinu Mammen, M.P.H.
(1)
,
Cathleen Kane, M.P.A.
(1)
,
James Holahan, M.P.H., M.S.
(1)
,
Miriam Bredella, M.D., M.B.A.
(1)
All Authors and Affiliations
Affiliations:
1. NYU Langone Health
Posted April 21, 2026
Featured CTSA Institutions:
New York University School of Medicine
Northwestern University
Other
MASALA team at the NYU CTSI Clinical Research Center.
Photo by: MASALA Study team
Summary
South Asians face some of the highest rates of heart disease worldwide yet have historically been underrepresented in U.S. research and clinical guidelines. The Mediators of Atherosclerosis in South Asians Living in America (MASALA) study — funded by over 24 million in NIH grants since 2010 and supported by Clinical and Translational Science Award (CTSA) infrastructure — has had a significant impact on addressing this gap. Data from MASALA informed both the 2018 American Heart Association/American College of Cardiology guidelines and the recently released 2026 multi-society dyslipidemia guidelines, which recognize South Asian ancestry as a risk-enhancing factor and recommend earlier screening. By translating long-term cohort data into national policy, this work is helping clinicians better identify and prevent heart disease in a population representing a growing segment of the U.S. and global population.
30%
Global deaths caused by heart disease
60%
Heart disease cases occur in South Asian populations
10+
Years of longitudinal data
Impact Story
The Problem
Heart disease is the leading cause of death worldwide, responsible for roughly 30% of all deaths. South Asians, people with origins from India, Pakistan, Bangladesh, Nepal, and Sri Lanka, Bhutan, and the Maldives, bear a disproportionate burden. Globally, they account for an estimated 60% of heart disease cases, and in the United States, they experience higher rates of atherosclerotic cardiovascular disease at younger ages compared to other groups.
Despite this risk, South Asians have historically been underrepresented in major U.S. studies. As a result, clinical guidelines often fail to reflect their unique risk profiles, leaving clinicians without clear direction on when and how to screen.
The Action
Launched between 2010 and 2013, the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study set out to address this gap. MASALA is the only large, longitudinal U.S. cohort focused specifically on South Asian Americans currently with over 5.4 million U.S. residents.
The study has enrolled more than 2,300 participants across multiple sites, including the University of California, San Francisco; Northwestern University; and, more recently, New York University. Critically, MASALA relied on Clinical and Translational Science Award (CTSA)–supported Clinical Research Centers at these institutions to conduct detailed, standardized clinical exams—ranging from fasting blood tests and imaging to culturally tailored surveys administered in multiple languages.
The Change
Over more than a decade of follow-up and rigorous data collection, MASALA generated an extensive body of evidence showing that South Asians develop cardiovascular risk factors earlier in life and face elevated risk not fully explained by traditional factors. The study has produced numerous peer-reviewed publications and has become a foundational data source for understanding cardiometabolic risk in South Asian populations.
The Impact
MASALA’s most significant impact is now reflected in national clinical practice. In recently updated multi-society dyslipidemia guidelines, South Asian ancestry is explicitly recognized as a risk-enhancing factor for cardiovascular disease. The guidelines also emphasize the need for earlier and more proactive screening in this population. Additionally, in 2015, the American Diabetes Association lowered the body mass index (BMI) criteria for screening Asian Americans for diabetes to 23 kg/m2 based on data generated in part from the MASALA Study.
This shift means clinicians can better identify high-risk patients earlier, leading to more timely prevention and treatment.
Why It Matters
South Asians represent 23% of the global population and are one of the fastest-growing populations in the United States with a substantial portion of the global population at risk for cardiovascular disease. By ensuring that this group is recognized in national guidelines, MASALA is helping shift clinical practice toward more evidence-based care.
This work also highlights the critical role of the CTSA program. Without CTSA-supported Clinical Research Centers, it would not have been possible to conduct the kind of rigorous, longitudinal, and culturally responsive data collection needed to generate these insights.
By connecting CTSI infrastructure, community-engaged research, and national policy, MASALA demonstrates how translational science can move from data to real-world impact—improving how disease is detected, prevented, and managed for millions of people.
“After [participating in] this program, I have seen that it has had good impact in the community. No such programs existed before [the MASALA study]. But now, through this program, people are becoming more careful about their health. People from the community are informing each other about the benefits of this program. They are inviting others to join. I think this is an advancement for the community.”
– MASALA Clinical Research Study Participant
