Association of diastolic blood pressure and coronary artery calcium in South Asian American adults

Meena Moorthy, Namratha R. Kandula, Nicola Lancki, Juned Siddique, Neela Thangada, Daichi Shimbo, Havisha Pedamallu, Alka M. Kanaya, Nilay S Shah*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Objective: DBP is associated with atherosclerosis and cardiovascular disease, independent of SBP. However, prior evaluation of the association of DBP with coronary artery calcium (CAC) has not included South Asian adults, a population that is at excess risk of atherosclerotic cardiovascular disease. Methods: In the Mediators of Atherosclerosis in South Asians Living in America (MASALA) Study, we evaluated the association of sex-specific DBP tertiles and CAC score at least 100 with robust Poisson regression adjusted for age, sex, SBP, BP medication use, and other cardiovascular risk factors. We examined these associations stratified by antihypertensive medication use, and secondarily the association of baseline DBP tertile with incident CAC at least 100 over median 4.7years of follow-up. Results: Among 1155 participants (48% women, mean age 57years), mean (standard deviation) DBP was 74 (10) mmHg, 33% were on antihypertensive medications, and 22% had CAC at least 100. Relative to DBP in tertile 1, DBP in tertiles 2 and 3 was associated with a significantly higher prevalence of CAC at least 100 [adjusted prevalence ratio 1.30 [95% confidence interval (CI) 1.03–1.65] and 1.47 (1.12–1.93), respectively]. These significant associations were primarily observed in participants who were not on antihypertensive medications. Baseline DBP tertile was not associated with incident CAC at least 100. Conclusion: Among South Asian adults in MASALA, DBP in the second or third tertiles vs. tertile 1 were associated with a higher prevalence of CAC at least 100 after adjustment for covariates including SBP. DBP may be an important clinical ASCVD risk factor among South Asian adults.

Original languageEnglish (US)
Article number10.1097/HJH.0000000000003940
JournalJournal of hypertension
DOIs
StateAccepted/In press - 2024

Funding

This project was supported by grant numbers R01HL093009 and K23HL157766 from the National Heart, Lung, and Blood Institute, and the National Center for Research Resources and the National Center for Advancing Translational Sciences, National Institutes of Health, through UCSF-CTSI grant numbers UL1RR024131 and UL1TR001872. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or the National Institutes of Health. This project was also supported in part by an American Heart Association Career Development Award # 24CDA1266732 ( https://doi.org/10.58275/AHA.24CDA1266732.pc.gr.193659 ). The authors thank the other investigators, the staff, and the participants of the MASALA study for their valuable contributions.

Keywords

  • atherosclerosis
  • cardiovascular disease
  • coronary artery calcium
  • DBP
  • heart disease risk factors
  • South Asian

ASJC Scopus subject areas

  • Internal Medicine
  • Physiology
  • Cardiology and Cardiovascular Medicine

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