Introduction: Atherosclerotic cardiovascular disease (ASCVD) is the leading cause of death among Americans. The burden of cardiometabolic risk factor clustering in ethnic subgroups is not well described for US Asians compared to other race/ethnicities. Methods: This cross-sectional study was conducted using electronic health data for White (N=634,200), Black (N=85,156), Hispanic (N=188,071), Filipino (N=78,000) and Chinese (N=72,545) Kaiser Permanente Northern California health plan members in 2016 who were aged 40-84y and had weight status assessed. We examined the proportions of men and women in each racial/ethnic group with clustered cardiometabolic risks (CCR), defined as having diabetes, hypertension, and obesity. Diabetes mellitus (DM) was based on a clinical DM diagnosis, lab criteria, or receipt of DM pharmacotherapy. Hypertension was defined by clinical diagnosis. Obesity was characterized by WHO standard (BMI ≥30 kg/m 2 ) and Asian-specific (BMI ≥27.5 kg/m 2 ) thresholds. Results: CCR prevalence varied by race/ethnicity, age, and the BMI criteria used for obesity (standard or Asian threshold). Use of the Asian threshold resulted in Filipinos having CCR prevalence that approached Blacks and Hispanics across all age groups (Figure). The Asian criterion nearly doubled the proportion of at-risk Filipinos, particularly older adults aged 65-84y. Filipinos had more than 2x higher CCR prevalence compared to Chinese. Among all ethnic groups except for Blacks, men were more likely than women to have CCR. Conclusion: Using an Asian-specific BMI obesity threshold, Filipino-Americans have a higher prevalence of cardiometabolic risk factor clustering than Chinese-Americans, resembling that of Blacks and Hispanics. Identifying Asian ethnicity in electronic health records could help facilitate earlier metabolic assessment and management to further reduce CVD burden, which may be especially important for men.
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