Abstract Body (Do not enter title and authors here): Introduction: South Asian populations are at enhanced ASCVD risk per clinical atherosclerotic cardiovascular disease (ASCVD) prevention guidelines, because they experience excess ASCVD at younger ages compared to other groups. However, the prevalence of ASCVD risk factors in young adult South Asians in the United States (US) has not previously been quantified.

Research Question: What is the prevalence of suboptimal cardiovascular risk factors among young adult South Asians in the US?

Methods: We enrolled US South Asian adults age ≥18 years who are children of participants in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) Study cohort from the Chicago metro area between 2022-2025. In this offspring cohort of second generation South Asian Americans, we assessed the prevalence of elevated blood glucose, non-high density lipoprotein cholesterol (non-HDL-C), systolic and diastolic blood pressure (SBP, DBP), and body mass index (BMI); and frequency of current/former smoking, ever vaping, suboptimal sleep duration, and non-zero coronary artery calcium (CAC). Life’s Essential 8 (LE8) cardiovascular health scores for these ASCVD risk factors were also calculated.

Results: Among 116 second generation South Asian Americans (mean age 34.3 [SD 9.3] years; 49% female, 51% male), the mean fasting glucose was 91 (7) mg/dL, 10 (9%) had fasting glucose 100-125 mg/dL, and none had fasting glucose ≥126 mg/dL. Mean non-HDL-C was 127 (31) mg/dL, and 51 (46%) had non-HDL-C ≥130 mg/dL. Mean SBP was 115 (12) mmHg, DBP was 73 (9) mmHg. There were 34 (31%) participants with SBP 120-139 mmHg and 3 (3%) with SBP ≥140 mmHg; and 18 (16%) of participants with DBP 80-89 mmHg and 7 (6%) with DBP ≥90 mmHg. Mean BMI was 25.3 kg/m², 46 (41%) had BMI 23 to <27.5 and 30 (27%) had BMI ≥27.5. Current or former smoking was present in 12 (10%) and ever vaping 24 (21%). Suboptimal sleep duration (<7 or ≥9 hours) was present in 36 (31%). Five (5%) participants had CAC score >0. Additional risk factor levels, risk factors stratified by sex, and LE8 cardiovascular health scores, are shown in the Table.

Conclusions: ASCVD risk factor prevalence is high among South Asian young adult participants in the MASALA-2G Second Generation Study, particularly elevated non-HDL-C and BMI and frequency of vaping. CAC prevalence is low. Early life course interventions to promote cardiovascular health and prevent incident ASCVD risk factors are needed for this population.