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Cited by 48Diabetes, Cardiovascular Risks, and LipoproteinsCardiovascular Health and Risk FactorsHealth Promotion and Cardiovascular Prevention

Heterogeneity in cardio-metabolic risk factors and atherosclerotic cardiovascular disease among Asian groups in the United States

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Satish, Priyanka, Sadaf, Murrium I., Valero-Elizondo, Javier, Grandhi, Gowtham R., Yahya, Tamer, Zawahir, Hassan, Javed, Zulqarnain, Mszar, Reed +5 more·2021·American Journal of Preventive Cardiology
DOI 10.1016/j.ajpc.2021.100219PMC PMC8387290
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Abstract

OBJECTIVE: The Asian American population in the U.S. comprises various, ethnically diverse subgroups. Traditionally, this population has been studied as a single, aggregated group, potentially masking differences in risk among subgroups. Analyses using disaggregated data can help better characterize the health needs of different Asian subpopulations and inform targeted, effective public health interventions. We assessed the prevalence of cardiovascular disease (CVD) risk factors and atherosclerotic CVD (ASCVD) and their associations with socioeconomic factors among Chinese, Asian Indian, Filipino and Other Asian subjects, compared with non-Hispanic White (NHW) subjects in the U.S. METHODS: : Cross-sectional study using data from 298,286 adults from the National Health Interview Survey (NHIS) from 2007 to 2018. We utilized chi-squared tests to compare characteristics across subgroups. Weighted proportions and unadjusted and adjusted logistic regression models were utilized to examine the associations between Asian subgroups, self-reported CVD risk factors and self-reported ASCVD, as well as between socioeconomic factors within each Asian subgroup. RESULTS: : Asian Indian subjects had the highest prevalence of diabetes (12.5%), while Filipino subjects had the highest prevalence of hyperlipidemia (27.7%), hypertension (29.8%) and obesity (19.8%). Despite this, the prevalence of self-reported ASCVD was lower in all Asian groups compared with NHWs. Chinese subjects had the lowest odds of having each of the CVD risk factors assessed. CONCLUSION: : We found considerable heterogeneity in the distribution of risk factors as well as ASCVD among Asian subgroups in the US. Compared with health system or community-based reports, the prevalence of risk factors and ASCVD may be underestimated in some Asian NHIS subgroups. There is an urgent need for efforts to improve recruitment of Asian participants of heterogeneous socioeconomic backgrounds in national surveys, as well as to perform a thorough assessment of risk factors and disease in this population, not relying solely on self-report.

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  • Emerging research suggests that some Asian subgroups, and Pacific Islanders, may be at higher risk for CVD and poorer outcomes than NHW, and that there are important differences among API subgroups.

    “Emerging research suggests that some Asian subgroups, and Pacific Islanders, may be at higher risk for CVD and poorer outcomes than NHW, and that there are important differences among API subgroups [4-8].”

    From Prevalence of cardiovascular disease among Asian, Pacific Islander and multi-race populations in Hawai’i and California (2023) · cites this paper as [7]

    The Introduction (page not specified) reports prior findings of higher ischemic heart disease prevalence and mortality among Asian Indian and Filipino people than among non-Hispanic White people. The Discussion (page not specified) reports substantial differences in cardiovascular risk factors across Asian subgroups. The paper does not establish the claim about Pacific Islanders; its own adjusted analysis also found no statistically significant difference in ASCVD odds between the Asian subgroups studied and non-Hispanic White respondents. (LLM, conf=0.88)

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  • Recent studies have highlighted both the need to disaggregate API subgroups and relatively higher CVD burden among some subpopulations, particularly South Asians and Filipinos.

    “Recent studies have highlighted both the need to disaggregate API subgroups [7, 8, 13, 14] and relatively higher CVD burden among some subpopulations, particularly South Asians and Filipinos [6, 15, 16].”

    From Prevalence of cardiovascular disease among Asian, Pacific Islander and multi-race populations in Hawai’i and California (2023) · cites this paper as [7]

  • Among Asian populations, study findings of higher prevalence of all three CVD conditions among Filipinos is consistent with previous reports of higher cardiometabolic risk and poorer health outcomes in this population.

    “Among Asian populations, study findings of higher prevalence of all three CVD conditions among Filipinos is consistent with previous reports of higher cardiometabolic risk and poorer health outcomes in this population [4, 7, 13, 15, 19, 22, 30-34].”

    From Prevalence of cardiovascular disease among Asian, Pacific Islander and multi-race populations in Hawai’i and California (2023) · cites this paper as [7]

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Authors
Satish, P., Sadaf, M. I., Valero-Elizondo, J., Grandhi, G. R., Yahya, T., Zawahir, H., Javed, Z., Mszar, R., Hanif, B., Kalra, A., Virani, S., Cainzos-Achirica, M., & Nasir, K.
Affiliations
  • Houston Methodist (US)
  • Yale University (US)
  • MedStar Union Memorial Hospital (US)
  • Yale New Haven Hospital (US)
  • College of Physicians and Surgeons Pakistan (PK)
  • Cleveland Clinic (US)
  • Michael E. DeBakey VA Medical Center (US)
Corresponding author
Nasir, Khurram
ORCID
Venue
American Journal of Preventive Cardiology
Publisher
Elsevier BV
Published
2021-09
Volume
7
Pages
100219
ISSN
2666-6677 (ISSN-L)
DOI
10.1016/j.ajpc.2021.100219
PMC
PMC8387290
OpenAlex
W3173506982
Cited by
48
References
57
Citations by year
2026: 7 · 2025: 11 · 2024: 8 · 2023: 9 · 2022: 11 · 2021: 2
FWCI
5.60
Type
journal article
Language
en
Open access
Licence
Locations
  • American Journal of Preventive Cardiology (publishedVersion, cc-by-nc-nd)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc-nd)
  • PubMed (publishedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • eCommons - AKU (Aga Khan University) (submittedVersion, cc-by-nc-nd)
Topics
  • Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Diabetes, Cardiovascular Risks, and Lipoproteins
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Health and Risk Factors
  • Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Health Promotion and Cardiovascular Prevention
Keywords
Asian Americans, atherosclerotic cardiovascular disease, cardiovascular risk factors, Chinese Americans, Asian Indian Americans, Filipino Americans, diabetes prevalence, hyperlipidemia, hypertension, obesity, socioeconomic factors, self-reported illness, National Health Interview Survey

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