Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois; Department of Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
Division of Cardiology, Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois.
J Card Fail. 2021 Nov;27(11):1214-1221. doi: 10.1016/j.cardfail.2021.05.013. Epub 2021 May 25.
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.
In the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, we calculated 10-year predicted HF 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, body 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]).
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.
南亚裔美国人患心血管疾病的负担不成比例地高。估计预测心力衰竭（HF）风险分布可能有助于有针对性地预防。我们估计了南亚裔美国人患心力衰竭的 10 年预测风险分布，并评估了其与健康社会决定因素和临床危险因素的关系。
在南亚裔美国人动脉粥样硬化的中介物（MASALA）研究中，我们使用预防心力衰竭多变量模型的 Pooled Cohort Equations 计算了 10 年预测 HF 风险。比较了整体和按人口统计学和临床特征划分的低（<1%）、中（1%-5%）和高（≥5%）HF 风险分布。我们使用有序逻辑回归评估了年龄和性别调整后的人口统计学特征和冠状动脉钙与预测 HF 风险类别的相关性。在 1159 名参与者（48%为女性）中，平均年龄为 57±9 岁，40%的人 HF 风险低，37%的人 HF 风险中，24%的人 HF 风险高。HF 风险分布在人口统计学（收入、教育、出生地）和临床（糖尿病、高血压、体重指数、冠状动脉钙）方面存在显著差异（P<0.01）。高预测 HF 风险与一系列收入（年收入 75000 美元或以上）（调整后的优势比 0.5[95%置信区间（CI）0.4-0.7]）、大学教育（0.6[95%CI 0.4-0.9]）、出生在另一个南亚国家（1.9[95%CI 1.2-3.2]，与出生在印度）和已确诊的冠状动脉钙（2.6[95%CI 1.9-3.6]）显著相关。
MASALA 队列中近三分之二的南亚裔美国人处于中等或高预测 10 年 HF 风险，其风险因人口统计学和临床特征而异。
