Abstract
Cardiovascular disease (CVD), including heart and cerebrovascular diseases, represents a leading cause of death in Asian Americans as a group. Much of our knowledge of CVD in Asian Americans has been based on studies that have either grouped Asian Americans together, or examined one Asian American subgroup alone. However, research that has compared Asian American subgroups, suggest marked heterogeneity in the prevalence of CVD and its risk factors among various subgroups (e.g., higher prevalence of coronary artery disease for Asian Indians and Filipinos). In this chapter, we will present our current understanding of CVD in Asian Americans with respect to: disease definitions, prevalence and epidemiology, cultural and structural barriers to health care, lifestyle and prevention, and future directions for research.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Allison, M. A., Criqui, M. H., McClelland, R. L., Scott, J. M., McDermott, M. M., Liu, K., et al. (2006). The effect of novel cardiovascular risk factors on the ethnic-specific odds for peripheral arterial disease in the Multi-Ethnic Study of Atherosclerosis (MESA). Journal of the American College of Cardiology, 48, 1190–1197.
Ayala, C., Croft, J. B., Greenlund, K. J., Keenan, N. L., Donehoo, R. S., Malarcher, A. M., et al. (2002). Sex differences in US mortality rates for stroke and stroke subtypes by race/ethnicity and age, 1995-1998. Stroke, 33, 1197–1201.
Barnes, P. M., Adams, P. F., & Powell-Griner, E. (2008). Health characteristics of the Asian adult population: United States, 2004-2006. Advance Data No., 394, 1–22.
Benfante, R. (1992). Studies of cardiovascular disease and cause-specific mortality trends in Japanese-American men living in Hawaii and risk factor comparisons with other Japanese populations in the Pacific region: A review. Human Biology, 64, 791–805.
Bild, D. E., Bluemke, D. A., Burke, G. L., Detrano, R., Roux, A. V. D., Folsom, A. R., et al. (2002). Multi-ethnic study of atherosclerosis: Objectives and design. American Journal of Epidemiology, 156, 871–881.
Bryant, L. L., Chin, N. P., Cottrell, L. A., Duckles, J. M., Fernandez, I. D., Garces, D. M., et al. (2010). Perceptions of cardiovascular health in underserved communities. Preventing Chronic Disease, 7, A30.
Burchfiel, C. M., Sharp, D. S., Curb, J. D., Rodriguez, B. L., Hwang, L.-J., Marcus, E. B., et al. (1995). Physical activity and incidence of diabetes: The Honolulu heart program. American Journal of Epidemiology, 141, 360–368.
Canto, J. G., Taylor, H. A., Jr., Rogers, W. J., Sanderson, B., Hilbe, J., & Barron, H. V. (1998). Presenting characteristics, treatment patterns, and clinical outcomes of non-black minorities in the National Registry of Myocardial Infarction 2. American Journal of Cardiology, 82, 1013–1018.
Carlisle, D. M., Leake, B. D., & Shapiro, M. F. (1995). Racial and ethnic differences in the use of invasive cardiac procedures among cardiac patients in Los Angeles County, 1986 through 1988. American Journal of Public Health, 85, 352–356.
Centers for Disease Control and Prevention. (2004). Disparities in premature deaths from heart disease-50 States and the District of Columbia, 2001. MMWR Morbidity and Mortality Weekly Report, 53, 121–125.
Central Intelligence Agency. (2010). The world fact book. Retrieved December 14, 2010, from https://www.cia.gov/library/publications/the-world-factbook/index.html.
Choi, S., Rankin, S., Stewart, A., & Oka, R. (2008). Perceptions of coronary heart disease risk in Korean immigrants with type 2 diabetes. Diabetes Educator, 34, 484–492.
Coronado, G. D., Woodall, E. D., Do, H., Li, L., Yasui, Y., & Taylor, V. M. (2008). Heart disease prevention Âpractices among immigrant Vietnamese women. Journal of Women’s Health, 17, 1293–1300.
Corrado, E., Rizzo, M., Coppola, G., Fattouch, K., Novo, G., Marturana, I., et al. (2010). An update on the role of markers of inflammation in atherosclerosis. Journal of Atherosclerosis and Thrombosis, 17, 1–11.
Cossrow, N., & Falkner, B. (2004). Race/ethnic issues in obesity and obesity-related comorbidities. The Journal of Clinical Endocrinology & Metabolism, 89, 2590–2594.
Criqui, M. H., Vargas, V., Denenberg, J. O., Ho, E., Allison, M., Langer, R. D., et al. (2005). Ethnicity and peripheral arterial disease: The San Diego population study. Circulation, 112, 2703–2707.
Davis, A. M., Vinci, L. M., Okwuosa, T. M., Chase, A. R., & Huang, E. S. (2007). Cardiovascular health disparities: A systematic review of health care interventions. Medical Care Research and Review, 64, 29S–100S.
Dawber, T. R., Meadors, G. F., & Moore, F. E., Jr. (1951). Epidemiological approaches to heart disease: The Framingham study. American Journal of Public Health Nations Health, 41 , 279–281.
Diamond, L. C., Wilson-Stronks, A., & Jacobs, E. A. (2010). Do hospitals measure up to the national culturally and linguistically appropriate services standards? Medical Care, 48, 1080–1087.
Eastwood, J.-A., & Doering, L. V. (2005). Gender differences in coronary artery disease. Journal of Cardiovascular Nursing, 20, 340–351.
Fang, J., Foo, S. H., Fung, C., Wylie-Rosett, J., & Alderman, M. H. (2006). Stroke risk among Chinese immigrants in New York city. Journal of Immigrant Minority Health, 8, 387–393.
Fang, J., Foo, S. H., Jeng, J.-S., Yip, P.-K., & Alderman, M. H. (2004). Clinical characteristics of stroke among Chinese in New York City. Ethnicity & Disease, 14, 378–383.
Flores, G. (2006). Language barriers to health care in the United States. The New England Journal of Medicine, 355, 229–231.
Fonarow, G. C., French, W. J., & Frederick, P. D. (2009). Trends in the use of lipid-lowering medications at discharge in patients with acute myocardial infarction: 1998 to 2006. American Heart Journal, 157, 185–194.
George, M. G., Tong, X., McGruder, H., Yoon, P., Rosamond, W., Winquist, A., et al. (2009). Paul Coverdell national acute stroke registry surveillance – four states, 2005–2007. Morbidity and Mortality Weekly Report: Surveillance Summaries, 58, 1–23.
Ghosh, C. (2003). Healthy people 2010 and Asian Americans/Pacific Islanders: Defining a baseline of information. American Journal of Public Health, 93, 2093–2098.
Gonzalez-Fernandez, M., Kuhlemeier, K. V., & Palmer, J. B. (2008). Racial disparities in the development of dysphagia after stroke: Analysis of the California (MIRCal) and New York (SPARCS) inpatient databases. Archives of Physical Medicine and Rehabilitation, 89, 1358–1365.
Han, H.-R., Kim, K. B., Kang, J., Jeong, S., Kim, E.-Y., & Kim, M. T. (2007). Knowledge, beliefs, and behaviors about hypertension control among middle-aged Korean Americans with hypertension. Journal of Community Health, 32, 324–342.
Hemann, B. A., Bimson, W. F., & Taylor, A. J. (2007). The Framingham risk score: An appraisal of its benefits and limitations. The American Heart Hospital Journal, 5, 91–96.
Heron, M. (2010). Deaths: Leading causes for 2006. National Vital Statistics Reports, 58, 1–95.
Higdon, J. V., & Frei, B. (2003). Tea catechins and polyphenols: Health effects, metabolism, and antioxidant functions. Critical Reviews in Food Science and Nutrition, 43, 89–143.
Hirsch, A. T., Criqui, M. H., Treat-Jacobson, D., Regensteiner, J. G., Creager, M. A., Olin, J. W., et al. (2001). Peripheral arterial disease detection, awareness, and treatment in primary care. Journal of the American Medical Association, 286, 1317–1324.
Holland, Ariel T., Wong, Eric C., Lauderdale, Diane S., & Palaniappan, Latha P. (2011). Spectrum of cardiovascular diseases in Asians-American racial/ethnic subgroups. Annals of Epidemiology, 21, 608–614.
Hwu, C. M., Hsiao, C.-F., Kuo, S.-W., Wu, K.-D., Ting, C.-T., Quertermous, T., et al. (2004). Physical inactivity is an important lifestyle determinant of insulin resistance in hypertensive patients. Blood Pressure, 13, 355–361.
Kagawa-Singer, M., & Kassim-Lakha, S. (2003). A strategy to reduce cross-cultural miscommunication and increase the likelihood of improving health outcomes. Academic Medicine, 78, 577–587.
Kandula, N. R., & Lauderdale, D. S. (2005). Leisure time, non-leisure time, and occupational physical activity in Asian Americans. Annals of Epidemiology, 15, 257–265.
Klatsky, A. L., Friedman, G. D., Sidney, S., Kipp, H., Kubo, A., & Armstrong, M. A. (2005). Risk of hemorrhagic stroke in Asian American ethnic groups. Neuroepidemiology, 25, 26–31.
Klatsky, A. L., & Tekawa, I. (2005). Health problems and hospitalizations among Asian-American ethnic groups. Ethnicity Disease, 15, 753–760.
Kuzawa, C. W., & Sweet, E. (2009). Epigenetics and the embodiment of race: Developmental origins of US racial disparities in cardiovascular health. American Journal of Human Biology, 21, 2–15.
Lloyd-Jones, D., Adams, R. J., Brown, T. M., Carnethon, M., Dai, S., De Simone, G., et al. (2010). Heart disease and stroke statistics–2010 update: A report from the American Heart Association. Circulation, 121, e46–e215.
Lusis, A. J. (2000). Atherosclerosis. Nature, 407, 233–241.
Marmot, M. G., & Syme, S. L. (1976). Acculturation and coronary heart disease in Japanese-Americans. American Journal of Epidemiology, 104, 225–247.
Marmot, M. G., Syme, S. L., Kagan, A., Kato, H., Cohen, J. B., & Belsky, J. (1975). Epidemiologic studies of coronary heart disease and stroke in Japanese men Âliving in Japan, Hawaii and California: Prevalence of coronary and hypertensive heart disease and associated risk factors. American Journal of Epidemiology, 102, 514–525.
Merchant, A. T., Kelemen, L. E., de Koning, L., Lonn, E., Vuksan, V., Jacobs, R., et al. (2008). Interrelation of saturated fat, trans fat, alcohol intake, and subclinical atherosclerosis. American Journal of Clinical Nutrition, 87, 168–174.
Misra, A., & Khurana, L. (2009). The metabolic syndrome in south Asians: Epidemiology, determinants, and prevention. Metabolic Syndrome Related Disorders, 7, 497–514.
Narayan, K. M. V., Aviles-Santa, L., Oza-Frank, R., Pandey, M., Curb, J. D., McNeely, M., et al. (2010). Report of a National Heart, Lung, and Blood Institute Workshop: Heterogeneity in cardiometabolic risk in Asian Americans in the U.S. opportunities for research. Journal of the American College of Cardiology, 55, 966–973.
National Center for Health Statistics, Centers for Disease Control and Prevention. (2001). Report to evaluate the U.S. standard certificates.
National Center for Health Statistics, Centers for Disease Control and Prevention. (2006). National Health and Nutrition Examination Survey: Screener module #1.
National Center for Health Statistics, Centers for Disease Control and Prevention. (2007). National Health and Nutrition Examination Survey, 2007-2008: Let’s improve our health. Hyattsville, MD: National Center for Health Statistics, Centers for Disease Control and Prevention.
National Center for Health Statistics, Centers for Disease Control and Prevention. (2009a). 2008 NHIS questionnaire – sample adult adult identification.
National Center for Health Statistics, Centers for Disease Control and Prevention. (2009b). Health, United States, 2008 with special feature on the health of young adults (Vol. DHHS publication No. 2009-1232). Hyattsville, MD: National Center for Health Statistics.
National Center for Health Statistics, Centers for Disease Control and Prevention. (2010). National Health and Nutrition Examination Survey: Note on 2007-2008 sampling methodology. Retrieved February 15, 2010, from http://www.cdc.gov/nchs/nhanes/nhanes2007-2008/sampling_0708.htm.
Nguyen, T. T., Liao, Y., Gildengorin, G., Tsoh, J., Bui-Tong, N., & McPhee, S. J. (2009). Cardiovascular risk factors and knowledge of symptoms among Vietnamese Americans. Journal of General Internal Medicine, 24, 238–243.
Nguyen-Huynh, M. N., & Johnston, S. C. (2005). Regional variation in hospitalization for stroke among Asians/Pacific Islanders in the United States: A nationwide retrospective cohort study. BMC Neurology, 5, 21.
Office of Minority Health and Bureau of Primary Health Care, Health Resources and Services Administration. (2005). Reducing health disparities in Asian American & Pacific Islander populations: What is cultural Âcompetence. Retrieved February 8, 2011, from http://erc.msh.org/aapi/cc4.html.
Office of Minority Health, U.S. Department of Health and Human Services. (2010). Asian American/Pacific Islander profile. Retrieved February 8, 2011, from http://minorityhealth.hhs.gov/templates/browse.aspx?lvl=3&lvlid=29.
Oza-Frank, R., Ali, M. K., Vaccarino, V., & Narayan, K. M. V. (2009). Asian Americans: Diabetes prevalence across U.S. and World Health Organization weight classifications. Diabetes Care, 32, 1644–1646.
Palaniappan, L. P., Araneta, M. R., Assimes, T. L., Barrett-Connor, E., Carnethon, M. R., Criqui, M. H., et al. (2010). Call to action: Cardiovascular disease in Asian Americans: A science advisory from the American Heart Association. Circulation, 122, 1242–1252.
Palaniappan, L. P., Mukherjea, A., Holland, A., & Ivey, S. L. (2010). Leading causes of mortality of Asian Indians in California. Ethnicity & Disease, 20, 53–57.
Palaniappan, L., Wang, Y., & Fortmann, S. P. (2004). Coronary heart disease mortality for six ethnic groups in California, 1990-2000. Annals of Epidemiology, 14, 499–506.
Pleis, J. R., Lucas, J. W., & Ward, B. W. (2009). Summary health statistics for U.S. adults: National Health Interview Survey, 2008. Vital Health Statistics, 10, 1–157.
Popkin, B. M., Horton, S., Kim, S., Mahal, A., & Shuigao, J. (2001). Trends in diet, nutritional status, and diet-related noncommunicable diseases in China and India: The economic costs of the nutrition transition. Nutrition Reviews, 59, 379–390.
Ren, J., & Kelley, R. O. (2009). Cardiac health in women with metabolic syndrome: Clinical aspects and pathophysiology. Obesity, 17, 1114–1123.
Rodriguez, B. L., D’Agostino, R., Abbott, R. D., Kagan, A., Burchfiel, C. M., Yano, K., et al. (2002). Risk of hospitalized stroke in men enrolled in the Honolulu Heart Program and the Framingham study: A comparison of incidence and risk factor effects. Stroke, 33, 230–236.
Schwartz, S. J., Unger, J. B., Zamboanga, B. L., & Szapocznik, J. (2010). Rethinking the concept of acculturation: Implications for theory and research. American Psychologist, 65, 237–251.
Sechena, R., Liao, S., Lorenzana, R., Nakano, C., Polissar, N., & Fenske, R. (2003). Asian American and Pacific Islander seafood consumption – a community-based study in King county, Washington. Journal of Exposure Analysis and Environmental Epidemiology, 13, 256–266.
Song, Y. J., Hofstetter, C. R., Hovell, M. F., Paik, H. Y., Park, H. R., Lee, J., et al. (2004). Acculturation and health risk behaviors among Californians of Korean descent. Preventive Medicine, 39, 147–156.
Spatz, E. S., Ross, J. S., Desai, M. M., Canavan, M. E., & Krumholz, H. M. (2010). Beyond insurance coverage: Usual source of care in the treatment of hypertension and hypercholesterolemia. Data from the 2003-2006 National Health and Nutrition Examination Survey. American Heart Journal, 160, 115–121.
Tang, H., Shimizu, R., & Chen, M. S., Jr. (2005). English language proficiency and smoking prevalence among California’s Asian Americans. Cancer, 104, 2982–2988.
Taylor, V. M., Yasui, Y., Tu, S.-P., Neuhouser, M. L., Li, L., Woodall, E., et al. (2007). Heart disease prevention among Chinese immigrants. Journal of Community Health, 32, 299–310.
Taylor-Piliae, R. E., Haskell, W. L., & Froelicher, E. S. (2006). Hemodynamic responses to a community-based Tai Chi exercise intervention in ethnic Chinese adults with cardiovascular disease risk factors. European Journal of Cardiovascular Nursing, 5, 165–174.
The Kaiser Family Foundation. (2008). Health coverage and access to care among Asian Americans, Native Hawaiians, and Pacific Islanders. Race, Ethnicity, & Health Care Fact Sheet. Menlo Park, CA: Kaiser Family Foundation.
Ton, T. G., Steinman, L., Yip, M.-P., Ly, K. A., Sin, M.-K., Fitzpatrick, A. L., et al. (2010). Knowledge of cardiovascular health among Chinese, Korean and Vietnamese immigrants to the US. Journal of Immigrant Minority Health, 13(1), 127–139.
U.S. White House Office of the Press Secretary. (2009, October 14). Executive Order: Increasing Participation of Asian Americans. Retrieved from http://www.whitehouse.gov/the-press-office/executive-order-asian-american-and-pacific-islander-community.
U.S. Census Bureau. (2001). Introduction to Census 2000 Data Products.
U.S. Census Bureau. (2008). B02006. Asian alone by selected groups. American Community Survey, 2006-2008.
U.S. Census Bureau. (2010). What is the census? Retrieved December 12, 2010, from http://2010.census.gov/2010census/about/.
Ueshima, H., Sekikawa, A., Miura, K., Turin, T. C., Takashima, N., Kita, Y., et al. (2008). Cardiovascular disease and risk factors in Asia: A selected review. Circulation, 118, 2702–2709.
Wild, S. H., Laws, A., Fortmann, S. P., Varady, A. N., & Byrne, C. D. (1995). Mortality from coronary heart disease and stroke for six ethnic groups in California, 1985 to 1990. Annals of Epidemiology, 5, 432–439.
Yagalla, M. V., Hoerr, S. L., Song, W. O., Enas, E., & Garg, A. (1996). Relationship of diet, abdominal obesity, and physical activity to plasma lipoprotein levels in Asian Indian physicians residing in the United States. Journal of the American Dietetic Association, 96, 257–261.
Ye, J., Rust, G., Baltrus, P., & Daniels, E. (2009). Cardiovascular risk factors among Asian Americans: Results from a National Health Survey. Annals of Epidemiology, 19, 718–723.
Yusuf, S., Hawken, S., Ounpuu, S., Dans, T., Avezum, A., Lanas, F., et al. (2004). Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): Case-control study. Lancet, 364, 937–952.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2013 Springer Science+Business Media, LLC
About this chapter
Cite this chapter
Holland, A.T., Palaniappan, L.P. (2013). Heterogeneity in Cardiovascular Health among Asian American Subgroups: Risk Factors, Outcomes, Treatment and Prevention, and Future Research Opportunities. In: Yoo, G., Le, MN., Oda, A. (eds) Handbook of Asian American Health. Springer, New York, NY. https://doi.org/10.1007/978-1-4614-2227-3_16
Download citation
DOI: https://doi.org/10.1007/978-1-4614-2227-3_16
Published:
Publisher Name: Springer, New York, NY
Print ISBN: 978-1-4614-2226-6
Online ISBN: 978-1-4614-2227-3
eBook Packages: Humanities, Social Sciences and LawSocial Sciences (R0)