title: Cardiovascular health metrics among South Asian adults in the United States: Prevalence and associations with subclinical atherosclerosis.
abstract: South Asians, a fast growing ethnic group in the US, have an increased risk for cardiovascular disease compared to the general population. We examined the prevalence and distribution of the American Heart Association's Life's Simple 7 cardiovascular health (CVH) metrics using data from Mediators of Atherosclerosis in South Asians Living in America (MASALA) study, and cross-sectional associations between number of CVH metrics in the ideal range with subclinical atherosclerosis assessed using coronary artery calcium (CAC) measured using cardiac computed tomography and carotid intima media thickness (CIMT) measured using high-resolution B-mode ultrasonography. CAC was modeled as Agatston scores=0, 1-400 and >400; CIMT was examined continuously and as internal CIMT>1.5mm. In the MASALA cohort (N=875; mean age: 55years; 53% men; living in greater San Francisco and Chicago areas; October 2010-March 2013) without prevalent coronary heart disease, no participant had all 7 metrics in ideal range; approximately 20% of the participants had at least 5 metrics in ideal range. Higher number of CVH metrics in the ideal range was inversely associated with subclinical atherosclerosis. A 1 unit increase in the number of CVH metrics in the ideal range was associated with 32% lower odds of CAC=1-400 (vs. CAC=0; OR=0.68, 95% CI: 0.60, 0.78) and 28% lower odds of internal CIMT>1.5mm (OR=72, 95% CI: 0.61, 0.85). These data show the prevalence of CVH metrics among South Asians in the US, and provide empirical evidence on inverse associations of meeting ideal levels for higher number of metrics and subclinical atherosclerosis.
authors.affiliation: Departments of Exercise and Nutrition Sciences and Epidemiology and Biostatistics, Sumner M. Redstone Global Center for Prevention and Wellness, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, NW, 2nd Floor, Washington, DC 20052, USA. Electronic address: sameera.talegawkar@alumni.tufts.edu.
authors.forename: Sameera A
authors.initials: SA
authors.lastname: Talegawkar
authors.affiliation: Department of Exercise and Nutrition Sciences, Milken Institute School of Public Health, The George Washington University, 950 New Hampshire Ave, NW, 2nd Floor, Washington, DC 20052, USA.
authors.forename: Yichen
authors.initials: Y
authors.lastname: Jin
authors.affiliation: Division of General Internal Medicine and Geriatrics, Department of Medicine, Northwestern University Feinberg School of Medicine, Rubloff Building 10th Floor, 750 N Lake Shore, Chicago, IL 6061, USA.
authors.forename: Namratha R
authors.initials: NR
authors.lastname: Kandula
authors.affiliation: Division of General Internal Medicine, Department of Medicine, University of California, San Francisco, 1545 Divisadero, San Francisco, CA 94115, USA.
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
mesh_terms: D001213:Asian / Q000706:statistics & numerical data*; D050197:Atherosclerosis / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000208:ethnology*; D059168:Carotid Intima-Media Thickness; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D014481:United States / Q000453:epidemiology
keywords: Cardiovascular health metrics; Prevention; South Asians; Sub-clinical atherosclerosis