Key result
Asian-American subgroups face higher proportionate mortality from hypertensive heart disease and stroke vs NHWs.
Why the study?
The current understanding of Asian-American cardiovascular disease mortality patterns is distorted by the aggregation of distinct subgroups.
Observational (n=10,442,034)
Significant heterogeneity exists in cardiovascular mortality patterns among Asian-American subgroups, highlighting a disproportionate burden of hypertensive heart disease and hemorrhagic stroke across these populations compared to Non-Hispanic Whites.
Answers are grounded in this paper and cite their sources.
Captured external expert commentary on this paper, strongest first. Original sources are linked where available.
“The messages on prevention and management of CVD are not effectively reaching this population. The lack of national mortality statistics for CVD among Asian Americans has made it difficult to recommend research agendas, to create public health policy, and to offer appropriate clinical guidelines.”
“For a long time, because Asian Americans were grouped into one category, it appeared that Asian people in the U.S. did not have as high a risk for heart and vascular diseases compared with other groups. Our findings indicate this is inaccurate. By separating Asian subgroups, we can identify populations and communities that are at higher cardiovascular disease risk, and they may benefit from enhanced heart”
“These findings show the importance of evaluating Asian American groups in health research individually, instead of grouped in a single 'Asian' category. Our results show that several Asian American subgroups are experiencing worrisome trends in death rates from CVD. For example, Asian Indians have the highest mortality rates from ischemic heart disease. Mortality from HF increased among several Asian American groups, including Filipino, Asian Indian and Japanese women and men.”
Supports disaggregated CVD surveillance in Asian-American subgroups; leaves open whether targeted interventions reduce observed mortality disparities.
Background Asian Americans are a rapidly growing racial/ethnic group in the United States. Our current understanding of Asian-American cardiovascular disease mortality patterns is distorted by the aggregation of distinct subgroups. Objectives To examine heart disease and stroke mortality rates in Asian-American subgroups to determine racial/ethnic differences in cardiovascular disease mortality within the United States. Methods We examined heart disease and stroke mortality rates for the 6 largest Asian-American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) from 2003–2010. U.S. death records were used to identify race/ethnicity and cause of death by ICD-10 coding. Using both U.S. Census and death record data, standardized mortality ratios (SMR), relative SMRs (rSMR), and proportional mortality ratios (PMR) were calculated for each sex and ethnic group relative to Non-Hispanic Whites (NHW). Results 10,442,034 death records were examined. While NHW men and women had the highest overall mortality rates, Asian Indian men and women and Filipino men had greater proportionate mortality burden from ischemic heart disease. The proportionate mortality burden of hypertensive heart disease and cerebrovascular disease, especially hemorrhagic stroke, was higher in every Asian-American subgroup compared to NHWs. Conclusions The heterogeneity in cardiovascular disease mortality patterns among diverse Asian-American subgroups calls attention to the need for more research to help direct more specific treatment and prevention efforts, in particular with hypertension and stroke, to reduce health disparities for this growing population.
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Jose et al. (2014) conducted an observational in Cardiovascular disease mortality (n=10,442,034). Asian-American race/ethnicity (Asian Indian, Chinese, Filipino, Japanese, Korean, Vietnamese) vs. Non-Hispanic Whites (NHW) was evaluated on Heart disease and stroke proportional mortality ratios (PMR). Proportionate mortality burden from hypertensive heart disease and cerebrovascular disease was higher in every Asian-American subgroup compared to Non-Hispanic Whites, while Asian Indians and Filipinos had higher proportionate mortality from ischemic heart disease.
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