Agarwala Anandita, Satish Priyanka, Ma Tsung-Wei, Ravindranathan Preethi, Vajramani Aashna, Balarbar Noah, Brumley Charles, Gami Abhishek, Nasir Khurram, Nambi Vijay, Butler Javed, Patel Jaideep
Center for Cardiovascular Disease Prevention, Baylor Scott and White Health Heart Hospital Baylor Plano, Plano, Texas, USA.
Center for Cardiovascular Prevention, Ascension Texas Cardiovascular, UT Dell Medical School, Austin, Texas, USA.
JACC Adv. 2024 Oct 30;3(12):101349. doi: 10.1016/j.jacadv.2024.101349. eCollection 2024 Dec.
Despite implementation of preventive interventions targeting cardiovascular disease (CVD), atherosclerotic CVD (ASCVD) remains a major public health concern in the South Asian (SA) population.
The purpose of this study was to assess the risk factor prevalence and ASCVD outcomes in SA population in the United States.
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.
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 < 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 < 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%, < 0.001; ezetimibe 8.6% vs 16.2%, = 0.009).
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.
尽管针对心血管疾病（CVD）实施了预防干预措施，但动脉粥样硬化性心血管疾病（ASCVD）仍是南亚（SA）人群主要的公共卫生问题。
本研究旨在评估美国SA人群中的危险因素患病率及ASCVD结局。
DIL健康与动脉健康纵向评估登记处回顾性收集了在贝勒·斯科特与怀特医疗保健系统接受治疗的SA成年患者的数据。进行了总体和按性别分层的分析，以评估传统CVD危险因素及不良ASCVD事件的患病率。
共纳入31781人（男性16644人，女性15137人）。ASCVD危险因素谱包括高脂血症（43.0%）、高血压（22.2%）、糖尿病（15.5%）和当前吸烟（3.6%）。与女性相比，男性的ASCVD危险因素更为普遍；高脂血症（55.0%对29.9%）、高血压（26.9%对17.1%）、糖尿病（18.5%对12.3%）和当前吸烟（6.18%对0.71%），差异均<0.001。ASCVD和早发性ASCVD的患病率分别为7.1%和2.5%。总体队列中ASCVD诊断的中位年龄为65岁（第一四分位数，第三四分位数：53，74），男性为64岁（第一四分位数，第三四分位数：52，73），女性为70岁（第一四分位数，第三四分位数：60，77）。与无ASCVD者相比，早发性ASCVD患者的危险因素更为普遍：高脂血症（89.3%对39.4%）、高血压（68.3%对17.8%）和糖尿病（39.2%对12.7%），差异均<0.001。高血压和高脂血症在男性和女性中与ASCVD的关联最为密切（比值比分别为：3.48 [95%置信区间：3.06 - 3.96]和3.53 [95%置信区间：3.01 - 4.17]）。早发性ASCVD的女性接受降脂治疗（他汀类药物：80.5%对92.1%，<0.001；依折麦布：8.6%对16.2%，=0.009）的可能性较小。
在美国居住的SA成年人中，ASCVD和早发性ASCVD较为普遍。需要努力优化危险因素治疗，以降低这一高风险人群中ASCVD的风险。
