Regional Disparities in Undiagnosed Hypertension Among South Asian Adults in the Bay Area and Central Valley: The PRANA Heart Study
- 1University of California, Berkeley
Abstract
BackgroundSouth Asians (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) experience a disproportionately high burden of cardiovascular disease, with hypertension serving as a major modifiable risk factor. Despite this elevated risk, hypertension often remains underdiagnosed, particularly in community settings with limited access to routine screening. This study assessed the prevalence of hypertension and undiagnosed hypertension among South Asian adults participating in community-based health screenings in Northern California and examined regional disparities between the San Francisco Bay Area and the Central Valley.
MethodsA cross-sectional survey-based study was conducted among adults attending screenings organized by Jeeva Clinic at religious and community institutions. Participants voluntarily completed a survey collecting demographic information, cardiovascular health history, lifestyle factors, and recent blood pressure measurements obtained either during screening or through self-report. A total of 300 participants were included in the final analysis.
ResultsAmong participants with sufficient blood pressure data for hypertension classification (n = 245), 82.9% met criteria for hypertension. Among participants with sufficient data to determine undiagnosed hypertension status (n = 244), 59.8% exhibited previously undiagnosed hypertension. Hypertension prevalence was significantly higher among participants in the Central Valley compared with the Bay Area (97.9% vs 71.0%, {chi}{superscript 2} = 31.2, p < 0.001). Undiagnosed hypertension was also substantially more prevalent in the Central Valley (91.7% vs 37.0%, {chi}{superscript 2} = 71.0, p < 0.001). In multivariable analysis, Central Valley region was associated with significantly higher odds of hypertension (OR = 14.29, 95% CI 2.89-70.63, p = 0.001), and higher BMI was independently associated with hypertension (OR = 1.26 per unit increase, 95% CI 1.10-1.43, p < 0.001).
ConclusionsThese findings highlight a high burden of hypertension and significant regional disparities among South Asian adults in Northern California, suggesting that a large proportion of cardiovascular risk in this population remains undetected in routine care settings. Community-based screening initiatives, such as Jeeva Clinic, may help identify individuals at elevated risk and improve early detection in underserved populations.
Related
- Office blood pressure measurement versus ambulatory blood pressure monitoring for detecting undiagnosed hypertension in an apparently healthy Mexican adult cohort: complementary central hemodynamic and arterial stiffness assessment
- Central obesity in regional and remote Australian adults: a population-based Bayesian study
- PU-Boost: ATwo-StageReliable-Sample Reconstruction Positive-Unlabeled Learning Framework for Screening Undiagnosed Hypertension
- Measurement error adjusted prevalence of undiagnosed hypertension in England: A cross-sectional study
- The effect of regional disparities in access to rehabilitation services on mortality among stroke patients : A Korean nationwide population-based retrospective cohort study
BibTeX
@misc{nalluri2026regional,
title = {{Regional Disparities in Undiagnosed Hypertension Among South Asian Adults in the Bay Area and Central Valley: The PRANA Heart Study}},
author = {V. Nalluri and D. J. Bhagat and S. Gunasekar and B. Zeng and S. Policepatil and W. Tseng},
howpublished = {medRxiv},
year = {2026},
month = sep,
doi = {10.64898/2026.09.13.26362810},
url = {https://www.medrxiv.org/content/10.64898/2026.09.13.26362810v1},
note = {CC BY-NC-ND},
}
RIS
TY - UNPB
TI - Regional Disparities in Undiagnosed Hypertension Among South Asian Adults in the Bay Area and Central Valley: The PRANA Heart Study
AU - V. Nalluri
AU - D. J. Bhagat
AU - S. Gunasekar
AU - B. Zeng
AU - S. Policepatil
AU - W. Tseng
PY - 2026
DA - 2026/09/13
PB - medRxiv
DO - 10.64898/2026.09.13.26362810
UR - https://www.medrxiv.org/content/10.64898/2026.09.13.26362810v1
AB - BackgroundSouth Asians (from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka) experience a disproportionately high burden of cardiovascular disease, with hypertension serving as a major modifiable risk factor. Despite this elevated risk, hypertension often remains underdiagnosed, particularly in community settings with limited access to routine screening. This study assessed the prevalence of hypertension and undiagnosed hypertension among South Asian adults participating in community-based health screenings in Northern California and examined regional disparities between the San Francisco Bay Area and the Central Valley. MethodsA cross-sectional survey-based study was conducted among adults attending screenings organized by Jeeva Clinic at religious and community institutions. Participants voluntarily completed a survey collecting demographic information, cardiovascular health history, lifestyle factors, and recent blood pressure measurements obtained either during screening or through self-report. A total of 300 participants were included in the final analysis. ResultsAmong participants with sufficient blood pressure data for hypertension classification (n = 245), 82.9% met criteria for hypertension. Among participants with sufficient data to determine undiagnosed hypertension status (n = 244), 59.8% exhibited previously undiagnosed hypertension. Hypertension prevalence was significantly higher among participants in the Central Valley compared with the Bay Area (97.9% vs 71.0%, {chi}{superscript 2} = 31.2, p < 0.001). Undiagnosed hypertension was also substantially more prevalent in the Central Valley (91.7% vs 37.0%, {chi}{superscript 2} = 71.0, p < 0.001). In multivariable analysis, Central Valley region was associated with significantly higher odds of hypertension (OR = 14.29, 95% CI 2.89-70.63, p = 0.001), and higher BMI was independently associated with hypertension (OR = 1.26 per unit increase, 95% CI 1.10-1.43, p < 0.001). ConclusionsThese findings highlight a high burden of hypertension and significant regional disparities among South Asian adults in Northern California, suggesting that a large proportion of cardiovascular risk in this population remains undetected in routine care settings. Community-based screening initiatives, such as Jeeva Clinic, may help identify individuals at elevated risk and improve early detection in underserved populations.
ER -