Language

English

Publication Date

12-1-2024

Journal

JACC: Advances

DOI

10.1016/j.jacadv.2024.101349

PMID

39817092

PMCID

PMC11734018

PubMedCentral® Posted Date

10-30-2024

PubMedCentral® Full Text Version

Post-print

Abstract

Background: Despite implementation of preventive interventions targeting cardiovascular disease (CVD), atherosclerotic CVD (ASCVD) remains a major public health concern in the South Asian (SA) population.

Objectives: The purpose of this study was to assess the risk factor prevalence and ASCVD outcomes in SA population in the United States.

Methods: The DIL Wellness and Arterial health Longitudinal Evaluation registry collected data retrospectively on SA adult patients receiving care in the Baylor Scott & White Healthcare system. Overall and sex stratified analyses were performed to assess the prevalence of traditional CVD risk factors and adverse ASCVD events.

Results: A total of 31,781 individuals were included (16,644 men, 15,137 women). ASVCD risk factor profile included hyperlipidemia (43.0%), hypertension (22.2%), diabetes mellitus (15.5%), and current smoking (3.6%). ASCVD risk factors were more prevalent among men compared to women; hyperlipidemia (55.0% vs 29.9%), hypertension (26.9% vs 17.1%), diabetes mellitus (18.5% vs 12.3%), and current smoking (6.18% vs 0.71%), all P < 0.001, respectively. The prevalence of ASCVD and premature ASCVD was 7.1% and 2.5%, respectively. The median age of ASCVD diagnosis was 65 (Q1, Q3: 53, 74) years in the overall cohort, 64 (Q1, Q3: 52, 73) years for men, and 70 (Q1, Q3: 60, 77) years for women. Risk factors were more prevalent in those with premature ASCVD as compared to those without ASCVD: hyperlipidemia (89.3% vs 39.4%), hypertension (68.3% vs 17.8%), and diabetes mellitus (39.2% vs 12.7%), all P < 0.001, respectively. Hypertension and hyperlipidemia were most strongly associated with ASCVD in both men and women (OR: 3.48 [95% CI: 3.06-3.96] and 3.53 [95% CI: 3.01-4.17]), respectively. Women with premature ASCVD were less likely to be prescribed lipid-lowering therapy (statins 80.5% vs 92.1%, P < 0.001; ezetimibe 8.6% vs 16.2%, P = 0.009).

Conclusions: ASCVD and premature ASCVD are prevalent among SA adults residing in the United States. Efforts toward risk factor treatment optimization are needed to slow the risk of ASCVD in this higher risk population.

Keywords

diabetes mellitus, ethnic, hypertension, prevention, sex differences, smoking, South Asian

Published Open-Access

yes

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