Abstract Body (Do not enter title and authors here): Background: People of South Asian origin are the fastest-growing immigrant population in the United States (US) and experience excess cardiovascular disease (CVD) risk. However, data on US South Asians are often aggregated and mostly reflect Indian-origin individuals, masking heterogeneity in CVD risk across diverse South Asian subgroups. We hypothesize that cardiovascular health profiles of South Asian subgroups differ, as measured by the American Heart Association’s Predicting Risk of Cardiovascular Disease Events (PREVENT) score, revealing opportunities to improve cardiovascular health in these populations.
Methods: The Mediators of Atherosclerosis in South Asians Living in America (MASALA) cohort is a multisite, prospective study of community-dwelling South Asian adults (40–84 years old). We expanded the cohort by recruiting 1,150 new participants of Bangladeshi and Pakistani origin from 2021-2025 using methods consistent with the original cohort (83% Indian-origin participants recruited in 2010–2013 and 2017–2018). Participants were free of CVD at baseline. We compared social and cardiovascular health factors between Bangladeshi, Pakistani, and Indian participants by gender and calculated individual 10-year CVD risk using PREVENT.
Results: The Table shows social, behavioral, and age-adjusted clinical characteristics for the three South Asian groups. Bangladeshis were more recent immigrants and had lower educational attainment than the other groups. Bangladeshi and Pakistani men had a higher prevalence of current smoking than Indian men. Physical activity levels were lower among Bangladeshi and Pakistani participants compared to Indian participants. Pakistani men and women had the highest BMI. Medication use (statins, antihypertensives, diabetes medications) was highest among Bangladeshis. The 10-year CVD risk score was highest for Pakistani men (10.4%), followed by Bangladeshi (9.9%) and Indian men (8.5%). Among women, Bangladeshi and Pakistani women had higher 10-year CVD risk (7.8% and 7.5%, respectively) than Indian women (5.9%).
Conclusions: There is substantial variability in social factors, CVD risk factor distribution, and estimated 10-year CVD risk across US South Asian groups. These findings underscore the need for tailored CVD prevention efforts, including smoking cessation among Bangladeshi and Pakistani men, diabetes prevention and physical activity promotion in Bangladeshi and Pakistani populations, and early treatment to reduce CVD risk.