Abstract

Introduction: Asian American subgroups (Asian Indian, Chinese, Filipino, Korean, Japanese, and Vietnamese) display significant differences in mortality due to cardiovascular disease. It has previously been proposed that cancer is the leading cause of death for all Asian Americans. However, recent analysis of each individual subgroup reveals that heart disease is actually the leading cause of death for Asian Indian, Filipino and Japanese populations. Additionally, certain Asian American subgroups have an increased burden of risk factors and disease mortality at younger ages when compared to Non-Hispanic Whites. Years of potential life lost (YPLL) provides a measure of premature mortality due to cardiovascular disease by taking into account race-specific life expectancy and the younger age at death that is specific to Asian American populations. Hypothesis: We assessed the hypothesis that certain subgroups, such as Asian Indian and Filipino populations, lost more years of life due to cardiovascular disease when compared to other Asian American subgroups and Non-Hispanic Whites. Methods: We used National Center for Health Statistics Multiple Causes of Death mortality files from 2003-2012. Sample size for Asian Americans was 354,256 and for Non-Hispanic Whites was 19,722,445. We calculated life expectancy, mean YPLL, and YPLL per 100,000 population for each Asian subgroup. We further characterized race-specific life expectancy using linear interpolation, and YPLL per 100,000 was standardized and age-adjusted using age categories. Results: Asian American subgroups display heterogeneity in cardiovascular disease burden. Asian Indians had a high burden of ischemic heart disease (IHD); Asian Indian men lost a mean of 17 years of life to IHD while Japanese and Non-Hispanic White men lost 14 years of life. Regarding cerebrovascular disease, Vietnamese populations lost a mean of 17 years of life, and Filipino populations lost a mean of 16 years. All Asian subgroups had higher years of life lost to cerebrovascular disease compared to Non-Hispanic Whites. Conclusion: Cardiovascular disease burden varies among Asian subgroups, and contributes to significant premature mortality in certain populations. Asian Indian and Filipino populations have the highest years of life lost due to ischemic heart disease. Filipino and Vietnamese have the highest years of life lost due to cerebrovascular disease. Mean YPLL due to cardiovascular disease was higher for Asian Indians, Korean, Vietnamese, and Filipino subgroups than mean YPLL for Non-Hispanic Whites. To address these health disparities, an analysis of risk factors is required and subgroup-specific interventions must be developed.

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