Hypertension guidelines and coronary artery calcification among South Asians: Results from MASALA and MESA
Year: 2021
Type: article
Abstract: Untreated hypertension may contribute to increased atherosclerotic cardiovascular disease (ASCVD) risk in South Asians (SA). We assessed HTN prevalence among untreated adults free of baseline ASCVD from the MASALA & MESA studies. The proportion of participants who received discordant recommendations regarding antihypertensive pharmacotherapy use by the 2017-ACC/AHA and JNC7 Guidelines across CAC score categories in each race/ethnic group was calculated. Compared with untreated MESA participants (n = 3896), untreated SA (n = 445) were younger (55±8 versus 59±10 years), had higher DBP (73±10 versus 70±10 mmHg), total cholesterol (199±34 versus 196±34 mg/dL), statin use (16% versus 9%) and CAC=0 prevalence (69% versus 58%), with fewer current smokers (3% versus 15%) and lower 10-year-ASCVD-risk (6.4% versus 9.9%) (all p<0.001). A higher proportion of untreated MASALA and MESA participants were diagnosed with hypertension and recommended anti-hypertensive pharmacotherapy according to the ACC/AHA guideline compared to JNC7 (all p<0.001). Overall, discordant BP treatment recommendations were observed in 9% SA, 11% Whites, 15% Blacks, 10% Hispanics, and 9% Chinese-American. In each race/ethnic group, the proportion of participants receiving discordant recommendation increased across CAC groups (all p<0.05), however was highest among SA (40% of participants). Similar to other race/ethnicities, a higher proportion of SA are recommended anti-hypertensive pharmacotherapy by ACC/AHA as compared with JNC7 guidelines. The increase was higher among those with CAC>100 and thus may be better at informing hypertension management in American South Asians.
Institutions: Virginia Commonwealth University Medical Center, Emory University, Baylor College of Medicine, Houston Methodist, Ollscoil na Gaillimhe – University of Galway, The University of Texas Southwestern Medical Center, University of California, San Francisco, Northwestern University, Michael E. DeBakey VA Medical Center
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $1,600
Awards: G1156594538, G1261793039, G1276754516, G1294553593, G1483344193, G1497137905, G1508998135, G1640378483, Clinical and Translational Science Institute, Wake Forest Clinical and Translational Science Award, G1922428914, G1983464145, G2095942735, G2144938473, G22458031, G2545476352, G2690160998, G2726417417, G2837638605, G283874107, G290884426, G291913881, G3093995152, G3106377335, G3581052147, G3595232572, G3667269547, G3990748671, G4309390892, G4401650913, G4590187187, G4986157935, G5075046117, G5108002584, Coronary artery cross-sectional area and cardiovascular risk in South Asians, G5605591545, G5653954166, G5654179670, G611940047, Institute for Clinical and Translational Research, G66341962, G6742279884, G6856766826, G713258703, G7166352866, G758528517, G78770644, G805458286, Clinical and Translational Science Award, G8145863542, Mediators of Atherosclerosis in South Asians Living in America, G8852914737, G9000004549, G9000004784, G9000006353, G9000017360, G9000019818, G9000025517, G9000058261, G9000063950, G9000065698, Diabetes Research and Engagement through Advanced Multilevel Science Center for Diabetes Translational Research (DREAMS-CDTR), G991334795
OpenAlex ID: W3132575718