4.5 Article

Distribution and Correlates of Incident Heart Failure Risk in South Asian Americans: The MASALA Study

Journal

JOURNAL OF CARDIAC FAILURE
Volume 27, Issue 11, Pages 1214-1221

Publisher

CHURCHILL LIVINGSTONE INC MEDICAL PUBLISHERS
DOI: 10.1016/j.cardfail.2021.05.013

Keywords

Heart failure; epidemiology; race and ethnicity; primary prevention

Funding

  1. National Heart, Lung, and Blood Institute (NHLBI) [5R01HL093009]
  2. National Center for Research Resources
  3. National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI [UL1RR024131]
  4. NHLBI [F32HL149187]
  5. American Heart Association [19TPA34890060]
  6. NIH's National Center for Advancing Translational Sciences [KL2TR001424]
  7. NIH's National Institute on Aging [P30AG059988]

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The study found that almost two-thirds of South Asian Americans in the cohort are at intermediate or high predicted 10-year HF risk, with varying risk across demographic and clinical characteristics.
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 I IF 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, hotly 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.

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