Abstract 19: Cardiovascular Health Amongst Asian-Americans: National Health and Nutrition Examination Study

Abstract

Background: Variable propensity towards cardiovascular disease amongst the different ethnicities in the United States (U.S.) has been reported. We aimed to characterize the prevalence of cardiovascular risk factors, as defined by the American Heart Association’s Life’s Simple 7 metrics amongst Asian-Americans. We also hypothesized that the prevalence of cardiovascular risk factors is changing among Asian-Americans and that that the prevalence varies between American-born and foreign-born Asian-Americans. Methods: The National Health and Examination Nutrition Study (NHANES) 2011-2016 cross-sectional surveys were used to evaluate the prevalence trends for cardiovascular risk factors adjusted for age, sex, educational attainment, family income to poverty ratio, and insurance status amongst self-identified Asian-Americans. We further divided foreign-born Asian-Americans into strata based on residence in the U.S. for < 10 years, 10-19 years, and > 20 years to assess the difference in the prevalence of cardiovascular risk factors between American-born and foreign-born Asian-Americans. The difference in the prevalence of cardiovascular risk factors between American-born and foreign-born Asian-Americans were adjusted for the same covariates as above and presented as odds ratios. Results: Amongst cardiovascular health metrics, the prevalence of Asian-Americans reporting no physical activity increased from 21.5% in 2011-2012 to 32.4% in 2015-2016 (p for linear trend = 0.001). The prevalence of Asian-American subjects reporting a healthy diet decreased from 44.1% in 2011-2012 to 36.8% in 2015-2016 (p for quadratic trend = 0.02). There was a concomitant decline in the prevalence of subjects with healthy weight (BMI<25 kg/m 2 ) from 60.5% in 2011-2012 to 55.3% (p for linear trend = 0.04). We did not observe any significant trend in smoking, total cholesterol, blood pressure and diabetes. Compared with American-born Asian-Americans, foreign-born Asian-Americans had lower odds of having a healthy diet [odds ratio (OR): 0.51; 95% confidence interval (CI): 0.35-0.74 in < 10 years; OR: 0.48; 95% CI: 0.34-0.64 in 10-19 years, and OR: 0.56; 95% CI: 0.41-0.76 in > 20 years]. Similarly, foreign-born Asian-Americans had lower odds of having hypertension (OR: 0.55; 95% CI: 0.36-0.82 in < 10 years; OR: 0.56; 95% CI: 0.41-0.76 in 10-19 years, and OR: 0.71; 95% CI: 0.51-0.99 in > 20 years) compared to the American-born Asian-Americans. Conclusions: In the NHANES 2011-2016 surveys, Asian-Americans exhibited a declining prevalence of healthy weight, ideal diet, and ideal physical activity levels. Compared with American-born Asian-Americans, foreign-born Asian-Americans had better diet and blood pressure. Further research should be undertaken to delineate trends amongst Asian-American sub-groups and optimal cardiovascular preventive and treatment strategies amongst Asian-Americans.