New funding for the landmark MASALA research study

July 20, 2021

The Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study has received new funding from the National Hearth, Lung, and Blood Institute (NHLBI) and the National Institute on Minority Health and Health Disparities (NIMHD) to expand the cohort’s diversity and continue investigating cardiovascular disease disparities in South Asian Americans. These grants will be used to better characterize differences in cardiovascular health between Bangladeshi, Indian, and Pakistani Americans and to better understand heart failure in the cohort.

The MASALA Study is the first longitudinal cohort study in South Asians. The study is co-led by Namratha Kandula, MD, professor of Medicine in the Division of General Internal Medicine and Geriatrics and co-director IPHAM's Center for Community Health at Northwestern University Feinberg School of Medicine, and Alka Kanaya, MD, professor of medicine University of California San Francisco School of Medicine. Kandula is also a professor of Preventive Medicine in the Division of Epidemiology. The original study and subsequent Exam 2, found that South Asians have significantly higher prevalence of diabetes and metabolic abnormalities at lower body mass indexes compared to other race/ethnic groups. South Asians were also found to have higher fat deposits around vital organs and in the muscles, which may also contribute to increased cardiovascular risk.

The original MASALA Study was comprised of only 6% Pakistanis and .5% Bangladeshis compared to 83% Asian Indians. There is important heterogeneity in cardiovascular risk among South Asians, with studies from Europe showing that Bangladeshis are at greatest risk and that social, behavioral, and structural factors contribute to disparities among South Asians. The majority of studies on South Asian American health are on Indians immigrants. The Understanding Health Disparities in Pakistani, Bangladeshi and Asian Indian Immigrants: the Role of Socio-Cultural Context, Acculturation and Resilience Resources grant aims to fill this gap with the recruitment of 600 Bangladeshis and 550 Pakistanis from the greater New York City and Chicago areas, into the MASALA cohort. The results of this new cohort will be compared to Asian Indians in the original MASALA Study to examine the burden of cardiovascular disease among diverse groups of South Asians. In addition to characterizing burden of cardiovascular disease, the effects of psychosocial factors, such as discrimination and acculturation, on cardiovascular health will be investigated.

The MASALA Study also received funding from NHLBI to characterize heart failure and heart failure with preserved ejection fraction (HFpEF) in South Asians. HFpEF is the most common form of heart failure, with mortality rates of 50% within 5 years. Currently, there are no treatments to reduce mortality rates, creating an urgent need to characterize the underlying mechanisms of disease. As South Asians experience higher rates of diabetes and metabolic abnormalities at normal body mass indexes, identifying the stages of heart failure in this at-risk group is vital, and could lead to new insights about the pathophysiology of heart failure in Asian populations. The Metabolic Effects and Mechanisms for Heart Failure in South Asians grant will fund a new Exam 3 that will measure heart failure stages among 850 MASALA participants and compare these results to the Multi-Ethnic Study of Atherosclerosis (MESA) study to determine if significant differences exist between race/ethnic groups. Understanding heart failure in diverse groups will pave the path for potential treatments.