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Author Notes:

Corresponding author at: Unjali P. Gujral, c/o Emory University, Hubert Department of Global Health, Rollins School of Public Health, 1518 Clifton Road, CNR 7040-L, Atlanta, GA 30322, USA. uguijral@emory.edu

These authors have contributed equally to the manuscript: UPG and AM

Unjali Gujral: Conceptualiztion, Formal analysis, Writing - original draft, Writing - review & editing.

Anurag Mehta: Formal analysis, Writing - original draft, Writing - review & editing.

Salman Sher: Formal analysis.

Irina Uphoff: Data curation.

Saket Kumar: Formal analysis, Data curation.

Salim S. Hayek, Yi-An Ko, Gary H. Gibbons: Data curation, Formal analysis.

Greg S. Martin: Conceptualiztion, Data curation.

Arshed A. Quyyumi: Funding acquisition, Conceptualization, Supervision, Writing - review & editing.

We would like to thank Shafaat A. Khan for his coordination of the Community Health Fairs.

We also thank the participants of the Community Health Fair Study, the Emory Predictive Health Initiative, and the META-Health Study for their important contributions.

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.


Research Funding:

UPG is supported by the NIDDK funded P30DK111024.


  • Arterial stiffness
  • Augmentation index
  • Cardiovascular disease
  • Ethnicity
  • Pulse wave velocity

Ethnic differences in subclinical vascular function in South Asians, Whites, and African Americans in the United States


Journal Title:

IJC Heart and Vasculature


Volume 30


, Pages 100598-100598

Type of Work:

Article | Final Publisher PDF


Background: South Asians are a high-risk ethnic group for cardiovascular disease despite having lower levels of conventional cardiovascular risk factors such as obesity and smoking. Ethnic differences in pulse wave reflections, arterial stiffness, and subclinical atherosclerosis as measured using augmentation index (AIX), pulse wave velocity (PWV), and carotid intima-media thickness (CIMT) may reflect some of this excess risk. Methods: We conducted a cross-sectional analysis of pooled data from three community-based sources in Atlanta, Georgia, USA. Data on 530 South Asians collected from local health fairs was compared with data on 507 White and 192 African Americans from the Emory Predictive Health Initiative and 351 White and 382 African Americans from the Morehouse and Emory Team up to Eliminate Health Disparities Study. Results: Linear regression models adjusted for age, sex, smoking, MAP, fasting glucose, TC, HDL-C, creatinine, and body mass index were used to assess the relationship between ethnicity and vascular function measures. In fully adjusted models, South Asians had higher heart rate corrected AIX as compared with Whites and African Americans (by 5.47%, p < 0.01 and 3.50%, p < 0.01; respectively), but lower PWV (by 0.51 m/s, p < 0.01 and 0.72 m/s, p < 0.01; respectively) and lower CIMT (by 0.02 mm p = 0.03 and 0.04 mm p < 0.01; respectively). Conclusions: Systemic pulse wave reflections, independent of other risk factors, are higher in South Asians as compared with Whites and African Americans. Future research is needed to determine whether higher AIX explains the increased cardiovascular risk among South Asians.

Copyright information:

© 2020 The Author(s)

This is an Open Access work distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (https://creativecommons.org/licenses/by-nc-nd/4.0/).
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