Distribution and Correlates of Incident Heart Failure Risk in South Asian Americans: The MASALA Study.
Distribution and Correlates of Incident Heart Failure Risk in South Asian Americans: The MASALA Study.
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DOI：
10.1016/j.cardfail.2021.05.013
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发表时间：
2021-11
影响因子：
6
通讯作者：
Khan SS
中科院分区：
文献类型：
--
作者：
Shah NS;Agarwal A;Huffman MD;Gupta DK;Yancy CW;Shah SJ;Kanaya AM;Ning H;Lloyd-Jones DM;Kandula NR;Khan SS
南亚裔美国人的心血管疾病负担不成比例地高。估计预测的心力衰竭（HF）风险分布可能有助于有针对性的预防。我们估计了南亚裔美国人10年预测的HF事件风险的分布，并评估了与社会决定因素和临床风险因素的相关性。在生活在美国的南亚人动脉粥样硬化的中介者（MASALA）研究中，我们使用预防心力衰竭的合并队列方程（PCP-HF）多变量模型计算了10年预测的HF风险。比较了低（<1%）、中等（1-5%）和高（≥5%）HF风险的分布，这些分布是根据总体和人口统计学及临床特征确定的。我们使用有序逻辑回归分析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化与预测的HF风险类别的相关性。在1，159名参与者（48%为女性）中，平均年龄57岁（标准差9），40%为低风险，37%为中等风险，24%为高风险。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[BMI]、冠状动脉钙化[CAC]）组之间存在显著差异（P<0.01）。观察到家庭收入≥ 75，000美元/年与高预测HF风险显著相关（调整后的比值比0.5 [95%置信区间0.4-0.7]），大学教育（0.6 [0.4-0.9]），出生地为另一个南亚国家（1.9 [1.2-3.2] vs.出生于印度），普遍CAC（2.6 [1.9-3.6]）。MASALA队列中几乎三分之二的南亚裔美国人处于中度或高度预测的10年HF风险，不同人口统计学和临床特征的风险不同。据估计，大多数中年南亚裔美国成年人在未来十年内发生心力衰竭的预测风险至少为中等，糖尿病在其心力衰竭风险中起着重要作用。
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 associations with social determinants 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 (PCP-HF) 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 1,159 participants (48% women), mean age 57 (standard deviation 9) years, 40% had low, 37% had intermediate, and 24% had high HF risk. Significant differences in HF risk distribution existed across demographic (income, education, birthplace) and clinical (diabetes, hypertension, body mass index [BMI], coronary artery calcium [CAC]) groups (P<0.01). Significant associations with high predicted HF risk were observed for family income ≥$75,000/year (adjusted odds ratio 0.5 [95% confidence interval 0.4–0.7]), college education (0.6 [0.4–0.9]), birthplace in another South Asian country (1.9 [1.2–3.2], vs. born in India), and prevalent CAC (2.6 [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. Most middle-aged South Asian American adults are estimated to be at least at intermediate predicted risk for developing heart failure over the next ten years, with diabetes having a large role in their heart failure risk.
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影响因子：
5.4
作者：
Kandula NR;Kanaya AM;Liu K;Lee JY;Herrington D;Hulley SB;Persell SD;Lloyd-Jones DM;Huffman MD
通讯作者：
Huffman MD
影响因子：
24
作者：
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通讯作者：
Westlake, Cheryl
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作者：
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通讯作者：
Palaniappan, Latha P.