Asian Americans make up the fastest-growing racial/ethnic group in the U.S., increasing 81% – from 11 million to 19 million – between 2000 and 2019. A large, retrospective study published today in Circulation: Cardiovascular Quality and Outcomes found that death rates for cardiovascular diseases in the U.S. varied among people from various Asian ethnicity subgroups.

“For a long time, because Asian Americans were grouped into one category, it appeared that Asian people in the U.S. did not have as high a risk for heart and vascular diseases compared with other groups,” said author Nilay S. Shah, M.D., M.P.H., an assistant professor of cardiology and preventive medicine at Northwestern University’s Feinberg School of Medicine in Chicago and an affiliated global faculty member at Stanford University’s Center for Asian Health Research and Education. “Our findings indicate this is inaccurate. By separating Asian subgroups, we can identify populations and communities that are at higher cardiovascular disease risk, and they may benefit from enhanced heart disease prevention and treatment strategies.”

The study compared the deaths of more than 600,000 Asian Americans with more than 30 million non-Hispanic white people and more than 2 million Hispanic people. The data showed:

• Death rates from ischemic heart disease significantly decreased between 2003-2017 in all women (For example, in 2003 vs. 2017, the rates decreased from 67 per 100,000 to 35 per 100,000, respectively, for Japanese women, and from 79 per 100,000 to 41 per 100,000, respectively, among Chinese women); significantly decreased in Chinese, Filipino, Japanese and Korean men, and non-Hispanic white and Hispanic men, while remaining stagnant in Asian Indian and Vietnamese men. (In 2003 vs. 2017, the ranges varied: remained the same level, at 71 per 100,000 among Vietnamese men; and decreased from 162 per 100,000 to 107 per 100,000, respectively, among Filipino men.) Asian Indian women had the highest death rates for ischemic heart disease in 2017.

• Heart failure death rates were unchanged in Chinese, Korean, and non-Hispanic white women and Chinese and Vietnamese men between 2003-2017; and significantly increased among Filipino, Asian Indian, and Japanese individuals, Vietnamese women, and Korean men. Asian Indian people had the highest heart failure death rates among all Asian American subgroups in 2017 (14 per 100,000 in women, 15 per 100,000 in men).

• Cerebrovascular disease death rates decreased among Chinese, Filipino and Japanese women, and men and did not shift among Asian Indian, Korean and Vietnamese women, and men. Vietnamese people had the highest cerebrovascular disease death rates in 2017.

“The Asian American population is very diverse in how the subgroups experience health outcomes,” said Shah. “It is important to recognize that evidence-based strategies that are effective for one population may not necessarily be effective for people in another group. There is tremendous opportunity to improve health for Asian Americans by focusing and tailoring research and care to the unique needs and cultural characteristics of these communities.”

An accompanying editorial by Monica Parks, M.D.; Brahmajee Nallamothu, M.D., M.P.H.; and P. Michael Ho M.D., Ph.D., notes that while this manuscript is an important contribution to the information available on this topic, it “only scratches the surface of needed research.” Nallamothu is editor-in-chief of the Circulation: Cardiovascular Quality and Outcomes journal, and Ho is deputy editor of the journal.

The study may be read here.

 Photo courtesy of the American Heart Association.