A recent study conducted in Northern California indicates that while cardiovascular disease (CVD) rates vary among Asian American subgroups, most of them are experiencing a faster increase compared to white adults. The research, which was presented at the American Heart Association’s Scientific Sessions in Chicago, found that only Japanese Americans and individuals of Native Hawaiian or Pacific Islander descent did not show a higher rate of increase. However, since the full results have yet to be published in a peer-reviewed journal, the findings remain preliminary.
Dr. Kaylin Thuy Nguyen, the study’s lead author and a clinical fellow in the division of cardiovascular medicine at Stanford University, emphasized the importance of analyzing data for specific Asian American groups rather than treating them as a single entity. “Asian Americans are a diverse group,” Nguyen stated. “There’s a lot of heterogeneity – different cultures, socioeconomic backgrounds, nutritional patterns. There are stark differences we mask when we aggregate data and look at the groups as a whole. If we assume the same risk for everyone, we might miss the opportunity to treat risk factors.”
Asian Americans and Pacific Islanders represent the fastest-growing racial or ethnic population in the United States. According to the 2020 census, approximately 24 million people identified as Asian alone or in combination with another racial or ethnic group. Among them, individuals of Chinese, Asian Indian, Filipino, Vietnamese, Korean, and Japanese descent accounted for 85%.
Historically, health data on individuals from these various Asian ancestries have been studied collectively, often obscuring significant variations in cardiovascular disease risk factors and prevalence. Recent research, however, has started to highlight these differences. This new study focused on analyzing cardiovascular disease rates among Asian American subgroups within a Northern California healthcare system and compared these rates with their white counterparts. The study also examined how the rates evolved between 2007 and 2018.
The researchers evaluated medical records of middle-aged Asian American men and women who self-identified as Asian Indian, Chinese, Filipino, Japanese, Korean, Native Hawaiian, or other Pacific Islander, as well as individuals of mixed-race backgrounds. The findings indicated that all Asian subgroups, with the exception of Japanese Americans and Native Hawaiians or Pacific Islanders, exhibited a faster increase in cardiovascular disease rates compared to white adults. Similarly, hypertension, or high blood pressure, rose more rapidly for nearly all subgroups—except Japanese Americans—when compared to white adults.
Among all the subgroups analyzed, Filipino Americans had the highest cardiovascular disease rates. Throughout the study period, their rates were nearly twice as high as those of their white peers. In 2007, 32.2% of Filipino Americans had cardiovascular disease, which increased to 45.1% in 2018. In contrast, white adults experienced a rise from 16.5% to 21.9% over the same period.
The study also found that coronary artery disease rates increased more rapidly among the Filipino, Asian Indian, and Chinese subgroups than among white adults. Meanwhile, the rate of heart attacks rose more slowly among Chinese and Korean individuals compared to their white counterparts.
The study did not explore the reasons behind these subgroup differences in cardiovascular risks and disease prevalence. However, Dr. Nguyen suggested that one potential explanation for the lower cardiovascular risk among Japanese Americans could be their traditional diet. She noted that their diet closely resembles the heart-healthy Mediterranean diet, emphasizing fish and vegetables while minimizing red meat consumption. Previous research has already linked the Japanese-style diet to reduced cardiovascular risk.
Lan Doan, an assistant professor in the department of population health at NYU Grossman School of Medicine in New York City, emphasized the necessity of collecting additional data in future studies. She pointed out that factors such as the length of time individuals have lived in the U.S., their regular access to healthcare, their insurance status, and their dietary and lifestyle adaptations should be considered in assessing cardiovascular risks. Geographic variations in these risks should also be examined.
“If we don’t start tracking and disaggregating data, we’re not going to be able to understand what differences in health there might be, and we can’t target treatments or preventive measures,” Doan stated.
She further emphasized the importance of deepening the understanding of Asian American, Native Hawaiian, and Pacific Islander populations. “We need to keep deepening our understanding of who these Asian American and Native Hawaiian and Pacific Islander populations are, and thinking about all the multilevel factors that influence the risk and progression of cardiovascular disease and risk factors across their lives,” she said.