Highlights
- •The majority of South Asians in MASALA are at intermediate or high 10-year heart failure risk.
- •Diabetes is an important heart failure risk factor in South Asian Americans.
- •Heart failure risk is associated with income, education, and birthplace in South Asian Americans.
Abstract
Background
South Asian Americans experience disproportionately high burden of cardiovascular
diseases. Estimating predicted heart failure (HF) risk distribution may facilitate
targeted prevention. We estimated the distribution of 10-year predicted risk of incident
HF in South Asian Americans and evaluated the associations with social determinants
of health and clinical risk factors.
Methods and Results
In the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study,
we calculated 10-year predicted HF risk using the Pooled Cohort Equations to Prevent
Heart Failure multivariable model. Distributions of low (<1%), intermediate (1%–5%),
and high (≥5%) HF risk, identified overall and by demographic and clinical characteristics,
were compared. We evaluated age- and sex-adjusted associations of demographic characteristics
and coronary artery calcium with predicted HF risk category using ordinal logistic
regression. In 1159 participants (48% women), with a mean age of 57 ± 9 years, 40%
had a low, 37% had an intermediate, and 24% had a high HF risk. Significant differences
in HF risk distribution existed across demographic (income, education, birthplace)
and clinical (diabetes, hypertension, body mass index, coronary artery calcium) groups
(P < .01). Significant associations with high predicted HF risk were observed for a
family of income 75,000/year or more (adjusted odds ratio 0.5 [95% confidence interval
(CI) 0.4–0.7]), college education (0.6 [95% CI 0.4–0.9]), birthplace in another South
Asian country (1.9 [95% CI 1.2–3.2], vs. born in India), and prevalent coronary artery
calcium (2.6 [95% CI 1.9–3.6]).
Conclusions
Almost two-thirds of South Asian Americans in the MASALA cohort are at intermediate
or high predicted 10-year HF risk, with varying risk across demographic and clinical
characteristics.
Key Words
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Article info
Publication history
Published online: May 25, 2021
Accepted:
May 18,
2021
Received in revised form:
May 17,
2021
Received:
March 4,
2021
Identification
Copyright
© 2021 Elsevier Inc. All rights reserved.
