Abstract

Introduction: Few studies have comprehensively examined if South Asian Americans develop atherosclerotic cardiovascular disease (ASCVD) risk factors at younger ages than other race/ethnicity groups. We compared ASCVD risk factors across age strata by race/ethnic group from two US community cohorts. Methods: We included 1164 South Asians from the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study and 2262 non-Hispanic White, 1892 Black, 1496 Hispanic, and 804 Chinese adults from the Multi-Ethnic Study of Atherosclerosis (MESA) study. Participants were 40-85 years (mean = 61.4, SD = 10.3) at initial exam. Mixed-effects linear or logistic regression models were used to predict the prevalence of risk factors by race/ethnic group at ages 45, 55, 65, and 75 years. We tested whether prevalence at age 45 and trends over time were different for South Asians compared to other groups. All models controlled for education, insurance status, and baseline smoking status. Results: At age 45, South Asians had a higher prevalence of hypertension than White, Chinese, and Hispanic/Latino adults, the highest prevalence of prediabetes or diabetes, and more dyslipidemia than Black and Chinese individuals. At age 45, South Asians reported higher diet quality and more exercise than other race/ethnic groups, and they also had significantly lower alcohol use than White, Black, and Hispanic groups. In addition, the change in these risk factors over time in South Asians differed from the trends in the other race/ethnic groups, (Table). Conclusions: South Asians have a high level of clinical risk factors and lower level of behavioral risk factors at age 45 compared to other race/ethnic groups. There are also different trends in risk factors with increasing age by race/ethnic group. Understanding trends and disparities in risk and protective factors across the lifecourse can help equitably improve prevention and treatment strategies for US populations.

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