Spectrum of Cardiovascular Diseases in Asian-American Racial/Ethnic Subgroups

Abstract

To compare the prevalence of coronary heart disease (CHD), stroke, and peripheral vascular disease (PVD) across Asian-American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, andVietnamese) and non-Hispanic white (NHW) subjects in a mixed-payer, outpatient health care organization in California. Electronic health records from 2007 to 2010 were examined for 94,423 Asian and NHW patients. Age-adjusted prevalence rates of CHD, stroke, and PVD, defined by physician International Classification of Diseases, Version 9, codes, were directly standardized to the NHW population. Age-adjusted odds ratios were calculated by the use of logistic regression for each Asian subgroup, by sex, compared with NHWs. The range of age-adjusted prevalence rates were: CHD (1.7%-5.2%), stroke (0.3%-1.8%), and PVD (0.9%-3.4%). The adjusted odds ratios of CHD were significantly higher for Filipino women (1.66; 95% confidence interval; 1.13-2.43) and men (1.47, 1.05-2.06) and Asian Indian men (1.77, 1.43-2.21), and significantly lower for Chinese women (0.72, 0.55-0.94) and men (0.78, 0.65-0.93), compared with NHWs. The odds of stroke were significantly greater for Filipino women (2.02, 1.22-3.34). The odds of PVD were generally lower for all Asian subgroups. There is considerable heterogeneity across Asian subgroups for prevalent CHD, stroke, and PVD. Future research should disaggregate Asian subgroups and cardiovascular outcomes to inform targeted prevention and treatment efforts.