Prevalence and Trends in Cardiovascular Risk Factors Among Middle‐Aged South Asian Adults Compared With Other Racial and Ethnic Groups in the United States: A Longitudinal Analysis of 2 Cohort Studies

Background People of South Asian background have a high burden of atherosclerotic cardiovascular disease (ASCVD). Few studies have examined if US South Asian individuals develop atherosclerotic cardiovascular disease risk factors at younger ages compared with other racial and ethnic groups. Methods Longitudinal data from all eligible participants (ie, those aged between 45 and 55 years at time of the baseline examination) in the MASALA (Mediators of Atherosclerosis in South Asians Living in America) and the MESA (Multi‐Ethnic Study of Atherosclerosis) cohort studies were combined. Data from all available examination visits (2010–2018 in MASALA and 2000–2018 in MESA) were used to estimate prevalence and change in prevalence of clinical and behavioral risk factors at ages 45 and 55 years for each racial and ethnic group and by gender. Results At age 45 years, South Asian individuals had the highest prevalence of prediabetes and hypertension compared with White, Chinese, and Hispanic individuals. South Asian men had a higher dyslipidemia prevalence than White, Chinese, and Black men, while South Asian women had a higher prevalence than Chinese and Black women. At age 55 years, South Asian adults had the highest estimated hazard probability of diabetes among all racial and ethnic groups. At an increased age, clinical risk factor prevalence increased in all racial and ethnic groups, diet quality improved, and the prevalence of no leisure‐time exercise decreased (ie, exercise improved). Conclusions Significant differences in risk factor prevalence were observed in South Asian adults compared with other US racial and ethnic groups at age 45 years. Understanding trends in cardiovascular risk and protective factors across the life course can help improve prevention and treatment strategies.