Association of cardiovascular health with subclinical coronary atherosclerosis progression among five racial and ethnic groups: The MASALA and MESA studies

Apr 7, 2024Atherosclerosis

Link between heart health and early artery plaque buildup over time in five racial and ethnic groups

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Abstract

Among 810 South Asian adults, optimal cardiovascular health metrics are associated with a lower incidence of coronary artery calcium.

26% of South Asian participants had optimal cardiovascular health metrics, compared to 28% of Non-Hispanic White participants and 21% of Other racial/ethnic groups.
Participants with optimal cardiovascular health at baseline were less likely to develop incident coronary artery calcium compared to those with inadequate metrics.
The incidence of coronary artery calcium was 24% for South Asians with optimal cardiovascular health, 28% for Non-Hispanic Whites, and 15% for Other groups.
No significant differences in annualized coronary artery calcium incidence or progression were observed between South Asian and other racial/ethnic groups.
Optimal blood pressure control was linked to lower coronary artery calcium incidence in South Asians and Other race/ethnic participants.

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BACKGROUND AND AIMS: South Asian adults (SA) are at higher risk for atherosclerotic cardiovascular disease (ASCVD) compared with other racial/ethnic groups. Life's Simple 7 (LS7) is a guideline-recommended, cardiovascular health (CVH) construct to guide optimization of cardiovascular risk factors. We sought to assess if the LS7 metrics predict coronary artery calcium (CAC) incidence and progression in asymptomatic SA compared with four other racial/ethnic groups.

METHODS: We assessed the distribution of CVH metrics (inadequate: score 0-8, average: 9-10, optimal: 11-14, and per 1-unit higher score) and its association with incidence and progression of CAC among South Asians in the Mediators of Atherosclerosis in South Asians Living in America (MASALA) study compared with other race/ethnic groups from the Multiethnic Study of Atherosclerosis (MESA).

RESULTS: We included 810 SA, 2622 Non-Hispanic White (NHW), and 4192 Other adults (collectively 1893 Black, 1496 Hispanic and 803 Chinese American participants, respectively). SA and White participants compared to Other race/ethnicity groups were more likely to have optimal CVH metrics (26% SA vs 28% White participants vs 21% Other, respectively, p < 0.001). Similar to NHW and the Other race/ethnic group, SA participants with optimal baseline CVH were less likely to develop incident CAC on follow-up evaluation compared to participants with inadequate CVH metrics, optimal CVH/CAC = 0: 24% SA, 28% NHW, and 15% Other (p < 0.01). In multivariable linear and logistic regression models, there was no difference in annualized CAC incidence or progression between each race/ethnic group (p = 0.85 and p = 0.17, respectively). Optimal blood pressure control was associated with lower CAC incidence among SA participants [OR (95% CI): 0.30 (0.14-0.63), p < 0.01] and Other race and ethnicity participants [0.32 (0.19-0.53), p < 0.01]. interaction interaction

CONCLUSIONS: Optimal CVH metrics are associated with lower incident CAC and CAC progression among South Asians, similar to other racial groups/ethnicities. These findings underscore the importance of optimizing and maintaining CVH to mitigate the future risk of subclinical atherosclerosis in this higher risk population.

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Association of cardiovascular health with subclinical coronary atherosclerosis progression among five racial and ethnic groups: The MASALA and MESA studies

Abstract

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