Background:
South Asians (individuals from India, Pakistan, Bangladesh, Nepal, and Sri Lanka) have high rates of cardiovascular disease (CVD) which cannot be fully explained by traditional risk factors. We created a community-based cohort of South Asians (MASALA) and compared the prevalence of coronary artery calcium (CAC) to four racial/ethnic groups in the Multi-Ethnic Study of Atherosclerosis (MESA).
Methods:
We compared 803 South Asians to the four racial/ethnic groups (2,622 Whites, 1,893 African Americans, 1,496 Latinos and 803 Chinese Americans), all free of CVD. We created pooled multivariate Poisson models to examine the effect of race/ethnicity with CAC after adjusting for sex, age, clinical site, education, smoking, BMI, diabetes, hypertension, HDL-, LDL-cholesterol, and cholesterol lowering medication use.
Results:
The age-adjusted prevalence of any CAC was similar between White and South Asian men (68%), but was lower in Latino (58%), Chinese American (58%) and African American men (51%). South Asian women had similar CAC prevalence as other ethnic minority women but significantly lower than White women (37% vs. 43%, p<0.05). The figure shows the mean CAC scores among each of the five racial/ethnic groups by 5-year increments in age. After adjusting for all covariates, South Asian men were similar to White men and had higher CAC scores compared to African Americans, Latinos and Chinese Americans. In fully adjusted models, CAC scores were similar for South Asian women compared to all MESA groups. However, South Asian women ≥70 years had a higher prevalence of any CAC than all other racial/ethnic groups.
Conclusions:
South Asian men are more similar to Whites than the other race/ethnic groups in MESA. The high burden of subclinical atherosclerosis in South Asians may partly explain higher rates of CVD in South Asians. Follow-up data from the MASALA study will determine whether CAC is associated with incident CVD among South Asians and if this relationship differs from that observed in other racial/ethnic groups.
Discordance between 10-year cardiovascular risk estimates using the ACC/AHA 2013 estimator and coronary artery calcium in individuals from 5 racial/ethnic groups: Comparing MASALA and MESA