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Author Notes:

Parag H Joshi, Division of Cardiology, Department of Internal Medicine, University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, E5.730F, Dallas, TX 75390, United States. Email: parag.joshi@utsouthwestern.edu

None of the authors received any funding any funding for the preparation of this manuscript. JP conceived the study design and wrote the initial draft of the manuscript; AM performed the analytic calculations and wrote the initial draft of the manuscript; MAR, MJB, KN, JWM, AP, AK, NRK, SSV, AA, GH, LS, and PHJ contributed to the design, writing, and provided critical review of the manuscript

The authors thank the other investigators, the staff, and the participants of the MASALA and MESA study for their valuable contributions. A full list of participating MASALA investigators and institutions can be found at https://www.masalastudy.org. A full list of participating MESA investigators and institutions can be found at http://www.mesa-nhlbi.org.

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:

MASALA: This research was supported by the National Institutes of Health (NIH) grant no. 1 R01 HL093009.

Data collection at UCSF was also supported by NIH/NCRR UCSF-CTSI Grant Number UL1 RR024131. MESA: This research was supported by contracts HHSN268201500003I, N01-HC-95159, N01-HC-95160, N01-HC-95161, N01-HC-95162, N01-HC-95163, N01-HC-95164, N01-HC-95165, N01-HC-95166, N01-HC-95167, N01-HC-95168 and N01-HC-95169 from the National Heart, Lung, and Blood Institute, and by grants UL1-TR-000040, UL1-TR-001079, and UL1-TR-001420 from NCATS.


  • Ethnic
  • Hypertension
  • Prevention
  • Risk
  • South Asian

Hypertension guidelines and coronary artery calcification among South Asians: Results from MASALA and MESA.

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Journal Title:

Am J Prev Cardiol


Volume 6


, Pages 100158-100158

Type of Work:

Article | Final Publisher PDF


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.

Copyright information:

© 2021 The Authors. Published by Elsevier B.V.

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