More Research Needed on Cardiovascular Disease in Asian-Americans

There are marked differences in heart disease risk and occurrence among Asian-American subgroups, but data on these subgroups is limited, prompting the American Heart Association to call for more research on this fastest-growing racial/ethnic group in the U.S., according to a scientific statement published in Circulation: Journal of the American Heart Association.

“Available research shows that subgroups of Asian-Americans are at increased risk of complications and death from cardiovascular disease; however, Asian-Americans are often studied as a group, which masks the differences within this heterogeneous population,” according to Latha Palaniappan, M.D., M.S., chair of the American Heart Association’s Scientific Advisory on Cardiovascular Disease in Asian-Americans.

Asian-Americans represent 25 percent of all foreign-born people in the U.S. They are projected to reach nearly 34 million by 2050. Major federal surveys have only recently started to classify Asian-Americans into seven subgroups: Asian Indian, Chinese, Filipino, Korean, Japanese, Vietnamese and Other Asian. The first six subgroups together constitute more than 90 percent of Asian-Americans in the U.S., according to the statement.

Palaniappan and her colleagues reviewed published research on Asian-Americans and cardiovascular disease, then identified gaps in knowledge and made recommendations.

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The statement cites some of the following risk differences between Asian-American subgroups:

* Asian Indians and Filipinos are at greater risk of coronary heart disease compared to the other subgroups.

* Japanese- and Chinese-Americans have lower rates of coronary heart disease but higher rates of stroke.

* Chinese-Americans have lower rates of peripheral arterial disease, or clotting diseases of the leg arteries, than other groups.

The statement identifies research showing that risk factors for Asian-Americans differ compared to Caucasians. For example, body mass index, a common tool for determining risk for cardiovascular disease, is considered normal when it’s less than 25 kg/m2 for Caucasians. However, a BMI under 23 kg/m2 may be more appropriate for Asians, she said.

Some studies also show that Asian-Americans metabolize drugs, including those used to treat heart disease, differently than Caucasians and other racial/ethnic groups.

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[“From the American Heart Association Call to Action: Cardiovascular Disease in Asian Americans. A Science Advisory,” by Latha P. Palaniappan, et al., can be downloaded as a PDF file here.]