American Indians and Pakistani Americans at high risk of cardiovascular disease: MASALA STUDY

Cardiovascular diseases (CVDs) are the leading cause of death globally, taking an estimated 17.9 million lives each year. In 2018, American Indians/Alaska Natives were 50 percent more likely to be diagnosed with coronary heart disease than their white counterparts. South Asian Americans experience a higher proportional mortality and higher burden of premature mortality from atherosclerotic cardiovascular disease (ASCVD) compared to non-Hispanic White and other Asian American groups.

"MASALA -Mediators of Atherosclerosis in South Asians Living in America STUDY" on American Indians and Pakistani Americans talks about the determinants of suboptimal cardiovascular health within South Asian American subgroups may help to tailor cardiovascular disease prevention strategies. Diet and socioeconomic position, may differ between South Asian subgroups, leading to differences in atherosclerotic cardiovascular diseases outcomes.

The study is published in American Heart Journal.

The objective of the study was to determine the factors that cause cardiovascular outcomes in South Asian subgroups.

The study included 1,018 South Asian immigrants in the San Fran cisco and Chicago metropolitan areas. Data were collected between October 2010-March 2018. MASALA participants were of South Asian ancestry (≥3 grandparents born in a South Asian country), age 40-84 years at enroll ment, and spoke English, Hindi, or Urdu. They included patients with prevalent CVD and weight >300 pounds. Immigrant participants were categorized by region of origin: Pakistan, or North or South India (health differ ences between these Indian geographic regognized and may be related to sociocultural and health related behavior differences recognized and may be related to sociocultural and health related behavior differences.

The results of the study are

• A total of 728 North Indian (mean age 58 years, 47% women), 223 South Indian (mean age 54 [9] years, 43% women), and 67 Pakistani (mean age 57 [9] years, 52% women) participants.

• Differences in total calorie, carbohydrate, and total fat intake were observed. Unadjusted hypertension prevalence was 56% in North Indian, 45% in South Indian, and 54% in Pakistani participants.

• Diabetes prevalence was 27% in North Indian, 29% in South Indian, and 33% in Pakistani participants. Dyslipidemia prevalence was 40% in North Indian, 55% in South Indian, and 55% in Pakistani participants. Obesity prevalence was 32% in North Indian, 27% in South Indian, and 48% in Pakistani.

Authors of Masala study concluded that "A combination of multilevel structural, sociocultural, and behavioral factors related to ethnicity and regional affiliation such as dietary pattern, physical activity norms, immigration factors, health care access, language barriers, and socioeconomic position, among others likely influence the development of heart disease in South Asians" further studies are required for development and implementation of preventive strategies that address multilevel determinants of atherosclerotic cardiovascular disease in South Asian Americans.

Reference: https://doi.org/10.1016/j.ahj.2021.10.115.