Abstract

Introduction: Cardiovascular disease (CVD) is the leading cause of death in the US. The prevalence of CVD risk factors and CVD mortality are heterogeneous among disaggregated Asian American subgroups; but little is known about when in the life course these differences arise. Hypothesis: We hypothesize that there are age-specific differences in the prevalence of CVD risk factors across Asian American subgroups that may predispose some subgroups to developing CVD at younger ages. Methods: We analyzed data from 78,559 Asian American adults enrolled in the National Health Interview Survey (2000-2018). CVD risk factors (hypertension, diabetes, high BMI, nicotine exposure, alcohol consumption, insufficient physical activity, and suboptimal sleep) and age were self-reported. We estimated the age-stratified prevalence of each CVD risk factor among Asian American subgroups (Filipino, Indian, Chinese, and “Other Asian”). Analyses accounted for the complex survey design. Results: The study population included 20.3% Chinese, 23.6% Filipino, 18.4% Indian, and 37.7% Other Asian groups. Filipinos had the highest prevalence of hypertension (6.4%, 95% CI: 5.1, 8.1), obesity (24.8%, 95% CI: 22.1, 27.7), alcohol consumption (67%, 95% CI: 63.7, 70.1), and suboptimal sleep (37.3%, 95% CI: 34.3, 40.4) at younger ages (18 - 34). The highest prevalence of diabetes was found in the Indian subgroup starting at ages 35 - 44 years. The Other Asian subgroup had highest prevalence of nicotine exposure (16.1%, 95% CI: 14.6, 17.7) at younger ages (18 - 34). The Chinese subgroup consistently had the lowest prevalence of CVD risk factors across age strata. Conclusions: Our findings show that Indian, Filipino, and Other Asian subgroups have a higher prevalence of most CVD risk factors at earlier ages compared to Chinese subgroup. This may explain why CVD prevalence among Chinese Americans is lower than other Asian subgroups. Our study demonstrates the importance of targeting CVD risk factors among susceptible Asian subgroups earlier in the life course.

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