Key result
Asian Americans show ~42% higher ideal CVH prevalence than whites, disappearing at lower BMI thresholds.
Why the study?
Asian Americans are the fastest growing population in the United States, but little is known about their cardiovascular health.
Does non-Hispanic Asian American race/ethnicity improve the prevalence of ideal cardiovascular health compared to non-Hispanic white race/ethnicity in US adults?
Cross-Sectional (n=6,764)
Yes
Does non-Hispanic Asian American race/ethnicity improve the prevalence of ideal cardiovascular health compared to non-Hispanic white race/ethnicity in US adults?
Relative Risk: 1.42 (95% CI 1.29–1.55)
Absolute Event Rate: 8.7% vs 5.9%
p-value: p=<0.001
Non-Hispanic Asian Americans appear to have better cardiovascular health metrics than non-Hispanic whites, but this advantage disappears when applying race-specific BMI thresholds.
NHAAs show higher ideal CVH than NHWs using standard metrics; leaves open whether ethnicity-specific BMI thresholds improve risk stratification in this population.
Background Asian Americans are the fastest growing population in the United States, but little is known about their cardiovascular health (CVH). The objective of this study was to assess CVH among non-Hispanic Asian Americans (NHAAs) and to compare these estimates to those of non-Hispanic white (NHW) participants. Methods and Results Merging NHANES (National Health and Nutrition Examination Survey) data from 2011 to 2016, we examined 7 metrics (smoking, weight, physical activity, diet, blood cholesterol, blood glucose, and blood pressure) to assess CVH among 5278 NHW and 1486 NHAA participants aged ≥20 years. We assessed (1) the percentage meeting 6 to 7 metrics (ideal CVH), (2) the percentage meeting only 0 to 2 metrics (poor CVH), and (3) the overall mean CVH score. We compared these estimates between NHAAs and NHWs and among foreign-born NHAAs by birthplace and number of years living in the United States. The adjusted prevalence of ideal CVH was 8.7% among NHAAs and 5.9% among NHWs ( P<0.001). NHAAs were significantly more likely to have ideal CVH (adjusted prevalence ratio: 1.42; 95% CI, 1.29-1.55) compared with NHWs. Among NHAAs, there was no significant difference in ideal CVH between US- and foreign-born participants, nor by number of years living in the United States. With lower body mass index thresholds (<23, normal weight) for NHAAs, there were no statistically significant differences in the adjusted prevalence of ideal CVH (6.5% versus 5.9%, P=0.216) between NHAAs and NHWs. Conclusions NHAAs had a higher prevalence of overall ideal CVH compared with NHWs. However, when using a lower body mass index threshold for NHAAs, there was no difference in ideal CVH between the groups.
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Fang et al. (2019) conducted a cross-sectional in Cardiovascular health (n=6,764). Non-Hispanic Asian American race/ethnicity vs. Non-Hispanic white race/ethnicity was evaluated on Ideal cardiovascular health (meeting 6 to 7 metrics) (PR 1.42, 95% CI 1.29-1.55, p=<0.001). Non-Hispanic Asian Americans had a higher prevalence of ideal cardiovascular health than non-Hispanic whites (PR 1.42; 95% CI 1.29-1.55), but this difference disappeared using lower BMI thresholds.
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