Cardiovascular Risk Factors among Asian Americans: Results from a National Health Survey

doi:10.1016/j.annepidem.2009.03.022

Annals of Epidemiology

Volume 19, Issue 10, October 2009, Pages 718-723

https://doi.org/10.1016/j.annepidem.2009.03.022 Get rights and content

Purpose

We assessed the prevalence of major cardiovascular disease (CVD) risk factors among Chinese, Asian Indian, Filipino, and other Asian populations compared to non-Hispanic Whites in the United States.

Methods

We analyzed aggregated data from the National Health Interview Survey (NHIS) from 2003 to 2005. Bivariate analyses were used to determine differences in the prevalence of CVD risk factors among Asian subgroups and white adults. Logistic regression analyses were also conducted to compare each Asian subgroup with white adults after taking sociodemographic variables into account.

Results

The unadjusted prevalence of physical inactivity was highest among Asian Indians and other Asians. After we controlled for covariates, Asian Indians still had higher odds of physical inactivity than Whites (odds ratio [OR] = 1.50, 95% confidence interval [CI] = 1.22–1.84). All Asian ethnic groups were significantly less likely than Whites to report smoking, obesity, and binge drinking. Compared with Whites, Filipinos were more likely to have hypertension (OR = 1.18, 95% CI = 1.02–1.44) and Asian Indians were more likely to have diabetes (OR = 2.27, 95% CI = 1.63–3.20).

Conclusion

Although Asian race was generally associated with lower risk for CVD, certain risk factors were particularly high among some Asian subgroups. Future interventions should specify the needs of specific subgroups and design culturally specific programs to reduce health risk behaviors in each Asian subpopulation.

Introduction

Asian Americans are one of the fastest growing minority populations in the United States (1). The 2000 U.S. Census showed that about 11.9 million Americans reported themselves as having either full or partial Asian heritage (2). In 2006, the Asian population increased to 14.6 million, accounting for 4.9% of the U.S. population. The largest ethnic subgroups are Chinese, Filipinos, and Asian Indians (3). Although the Asian population represents a diverse and multifaceted group of individuals, in epidemiologic research, Asian Americans have traditionally been identified as a homogeneous group or labeled as “other” 1, 4, 5, 6. The small sample size of the Asian population in national surveys adds more difficulties for researchers to evaluate health profiles for Asian subgroups.

Cardiovascular disease (CVD) is the leading cause of death among Asian Americans in the United States (1). Major risk factors for heart disease include high blood cholesterol, hypertension, diabetes, cigarette smoking, binge drinking, obesity, and physical inactivity 7, 8, 9, 10. There is very limited evidence on cardiovascular risk factors in subgroups of Asian Americans. Some local studies have indicated variation in CVD risk factors among Asian American subgroups. For example, a study using data from Asian Americans in northern California showed Filipino persons to be at greater risk of hypertension as compared to other ethnic groups (11). Another study on smoking prevalence among California's Asian Americans found that Korean and Vietnamese males had higher smoking prevalence rates than males in other subgroups. Although Asian females generally had low smoking prevalence rates, there were significant differences between subpopulations, ranging from 1.1% (Vietnamese women) to 12.7% (Japanese women) (12).

To date, no prior study has comprehensively examined CVD risk factors among Asian American subgroups using nationally representative samples. By using 3 years of aggregated data from the National Health Interview Survey (NHIS; 2003–2005), this study assessed the prevalence of major CVD risk factors among Chinese, Asian Indian, Filipino, and other Asian populations compared to non-Hispanic Whites in the United States.

Section snippets

Data Sources

The data for this study were derived from the 2003–2005 NHIS. The NHIS is an annual household interview of the civilian non-institutionalized population in the United States conducted by the National Center for Health Statistics (http://www.cdc.gov/nchs/nhis.htm). The NHIS used a multistage sampling method and collected data using computer-assisted personal interviewing, with a new sample of respondents interviewed each year. The sample was weighted to account for the complex sampling design

Results

The sociodemographics of non-Hispanic Whites and Asian ethnic groups are shown in Table 1. Asian Indian and Chinese persons were more likely to be married. Asian Indian, Chinese, and Filipino subgroups had higher percentage of people who had high school or higher than high school education and had better reported health status as compared to Whites and other Asians.

The unadjusted prevalence estimates of CVD risk factors among different ethnic groups are presented in Table 2. White and Filipino

Discussion

Using national survey data, our study found important differences in CVD risk factors among Asian Indian, Chinese, Filipino, other Asian, and non-Hispanic white adults. Asian Americans examined in this study shared some similarities in sociodemographics. However, there were obvious variations among these subgroups in education level and reported health status. These findings confirm the findings of several previous studies that Asian communities are diverse in many social and cultural areas and

Conclusions

Our study suggests that even though Asian ethnicities are generally associated with lower risks for CVD, certain risk factors were particularly high among some Asian ethnic groups. It is important for future research to consider the high degree of heterogeneity across subpopulations and to examine in detail the specific health concerns of the most vulnerable groups.

The paucity of health data and information for Asian Americans has created a significant problem in accurately assessing health

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Cardiovascular Risk Factors among Asian Americans: Results from a National Health Survey

Purpose

Methods

Results

Conclusion

Introduction

Section snippets

Data Sources

Results

Discussion

Conclusions

Am J Clin Nutr

Soc Sci Med

Ann Epidemiol

Am J Cardiol

Am J Cardiol

J Chronic Dis

J Stroke Cerebrovasc Dis

Moving forward: Addressing the health of Asian American and Pacific Islander women

Am J Public Health

Toward improved health: disaggregating Asian American and Native Hawaiian/Pacific Islander data

Am J Public Health

Effects of combining disparate groups in the analysis of ethnic differences: variations among Asian American mental health service consumers in level of community functioning

Am J Community Psychol

Ethnic differences in cardiovascular disease

Heart

Actual causes of death in the United States, 2000

JAMA

Impact of high-normal blood pressure on the risk of cardiovascular disease

N Engl J Med