South Asians in the United States particularly North and South Indian and Pakistani Americans have a disproportionately high incidence of cardiovascular disease compared to other race/ethnic groups, with up to 43% higher proportional mortality from ischemic heart disease in Asian Indian men compared with non-Hispanic white men, according to a new study.
Consequently, the American Heart Association identifies South Asian ethnicity as an ACSVD “risk-enhancing” factor, according to the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study published in the American Heart Journal.
According to the study, hypertension prevalence was highest in North Indian participants (54%); dyslipidemia prevalence was highest in South Indian and Pakistani participants (55%). Unadjusted diabetes (33%) and obesity prevalence (48%) were highest in Pakistani participants.
South Indian participants had higher odds of dyslipidemia compared with North Indian participants in fully adjusted models, according to the study conducted by six Indian American researchers.
“As differences in cardiovascular risk factors were observed across South Asian American subgroups, identifying the determinants of suboptimal cardiovascular health within South Asian American subgroups may help to better tailor cardiovascular disease prevention strategies,” the study suggested.
As South Asians are a heterogeneous population, the study evaluated differences in prevalence and adjusted odds of cardiovascular risk factors including diabetes, hypertension, dyslipidemia, and obesity between North Indian, South Indian, and Pakistani immigrants in the United States.
Given cultural differences among residents of Indian regions, for example in dietary patterns, the study further categorized Indian participants as North or South Indian.
The study was conducted with 1,018 participants (728 North Indian [47% women], 223 South Indian [43% women], 67 Pakistani [52% women]).
The study was completed by Neha K.Reddy, Unjali P.Gujral and Nilay S.Shah of Northwestern University Feinberg School of Medicine, Chicago, IL; Vaidehi Kaushal of Austin Dell Medical School, Austin, TX; Alka M.Kanaya of Emory University Rollins School of Public Health, Atlanta, GA and Namratha R.Kandula of the University of California – San Francisco. Reddy and Kaushal were listed as the first co-authors