Association of Acculturation with Cardiovascular Risk Factors in Asian-American Subgroups

LI, Yuemeng; ZHU, Alicia; LE, Austin; SINGH, Jaiveer; Palaniappan, Latha; Srinivasan, Malathi; Shah, Nilay S.; Wong, Sally S.; Elfassy, Tali; Yang, Eugene

doi:10.1016/j.ajpc.2022.100437

Cited by 10 publications

(3 citation statements)

References 33 publications

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“…Chinese, Filipino, Asian Indian, etc.). Studies that analyze cardiometabolic health by Asian subgroup, often show significant disparities such as increased blood pressure and increased odds of hypertension in certain Asian subgroups such as Filipino and South Asian adolescents [28,29] and adults [21,23,[30][31][32]. Our lack of subgroup aggregation may play a role in why we did not find significant disparities in blood pressure and hypertension status in our study.…”

Section: Discussioncontrasting

confidence: 56%

Cardiometabolic Health in Asian American Children

Sethna,

Wong,

Meyers

2023

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BackgroundThe aim was to compare cardiometabolic health between Asian American children and Non-Hispanic White (NHW) children as well as to compare cardiometabolic health among Asian American children by birthplace.MethodsChildren aged 6-17 years enrolled in the National Health and Nutrition Examination Survey (NHANES) from 2011-2018 who self-identified as non-Hispanic Asian and NHW were included. Among Asian Americans, place of birth was defined as foreign-born vs United States (US)-born. Regression models were adjusted for age, sex, household income, food insecurity, passive smoke exposure, and body mass index (BMI) z-score.ResultsAmong 3369 children, 8.4% identified as Asian American (age 11.7 years) and 91.6% identified as NHW (age 11.7 years). Compared to NHW children, Asian American children had significantly lower BMI z-scores and odds of obesity. Asian American children had higher HOMA-IR and uric acid, and greater odds of dyslipidemia, microalbuminuria and glomerular hyperfiltration compared to NHW children. Among Asian Americans, 30.5% were foreign-born. Compared to foreign-born Asian American children, US-born Asian American children had significantly higher non-HDL, triglycerides, HOMA-IR and uric acid, lower HDL, and lower odds of hyperfiltration. There were no differences in blood pressure by racial group or place of birth.ConclusionsAlthough Asian American children have lower odds of obesity, they have significantly worse glucose intolerance, higher serum uric acid levels, more dyslipidemia and more microalbuminuria compared to NHW children. US-born Asian American children have worse cardiometabolic health profiles compared to foreign-born Asian Americans.

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Section: Discussioncontrasting

confidence: 56%

Cardiometabolic Health in Asian American Children

Sethna,

Wong,

Meyers

2023

Preprint

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“… 34 Our group has previously demonstrated that higher levels of acculturation are associated with higher prevalence of cardiovascular risk factors among Asian immigrants in the NHIS. 35 …”

Section: Discussionmentioning

confidence: 99%

Social Determinants of Cardiovascular Risk Factors Among Asian American Subgroups

Zhu,

Le,

et al. 2024

JAHA

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Background Social determinants of health (SDOH) play a significant role in the development of cardiovascular risk factors. We investigated SDOH associations with cardiovascular risk factors among Asian American subgroups. Methods and Results We utilized the National Health Interview Survey, a nationally representative survey of US adults, years 2013 to 2018. SDOH variables were categorized into economic stability, neighborhood and social cohesion, food security, education, and health care utilization. SDOH score was created by categorizing 27 SDOH variables as 0 (favorable) or 1 (unfavorable). Self‐reported cardiovascular risk factors included diabetes, high cholesterol, high blood pressure, obesity, insufficient physical activity, suboptimal sleep, and nicotine exposure. Among 6395 Asian adults aged ≥18 years, 22.1% self‐identified as Filipino, 21.6% as Asian Indian, 21.0% as Chinese, and 35.3% as other Asian. From multivariable‐adjusted logistic regression models, each SD increment of SDOH score was associated with higher odds of diabetes among Chinese (odds ratio [OR], 1.45; 95% CI, 1.04–2.03) and Filipino (OR, 1.24; 95% CI, 1.02–1.51) adults; high blood pressure among Filipino adults (OR, 1.28; 95% CI, 1.03–1.60); insufficient physical activity among Asian Indian (OR, 1.42; 95% CI, 1.22–1.65), Chinese (OR, 1.58; 95% CI, 1.33–1.88), and Filipino (OR, 1.24; 95% CI, 1.06–1.46) adults; suboptimal sleep among Asian Indian adults (OR, 1.20; 95% CI, 1.01–1.42); and nicotine exposure among Chinese (OR, 1.56; 95% CI, 1.15–2.11) and Filipino (OR, 1.50; 95% CI, 1.14–1.97) adults. Conclusions Unfavorable SDOH are associated with higher odds of cardiovascular risk factors in Asian American subgroups. Culturally specific interventions addressing SDOH may help improve cardiovascular health among Asian Americans.

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“…For example, Vietnam is a developing country with a tropical climate, which faces a different profile of infectious tropical diseases [6]. In addition, longitudinal studies focused on the health trends of Asian immigrants have found significant correlations between acculturation and higher risks of excess body mass, diabetes mellitus, and poor cardiovascular health [7]. Immigrants are at greater risk for cardiometabolic disease compared to inhabitants of their country of origin [8,9].…”

Section: Introductionmentioning

confidence: 99%

Leading causes of death in Vietnamese Americans: An ecological study based on national death records from 2005–2020

Tran,

Shon,

Phan

et al. 2024

PLoS ONE

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Background Disaggregated data is a cornerstone of precision health. Vietnamese Americans (VietAms) are the fourth-largest Asian subgroup in the United States (US), and demonstrate a unique burden of disease and mortality. However, most prior studies have aggregated VietAms under the broader Asian American category for analytic purposes. This study examined the leading causes of death among VietAms compared to aggregated Asian Americans and non-Hispanic Whites (NHWs) during the period 2005–2020. Methods Decedent data, including underlying cause of death, were obtained from the National Center for Health Statistics national mortality file from 2005 to 2020. Population denominator estimates were obtained from the American Community Survey one-year population estimates. Outcome measures included proportional mortality, age-adjusted mortality rates per 100,000 (AMR), and annual percent change (APC) in mortality over time. Data were stratified by sex and nativity status. Due to large differences in age structure, we report native- and foreign-born VietAms separately. Findings We identified 74,524 VietAm decedents over the study period (71,305 foreign-born, 3,219 native-born). Among foreign-born VietAms, the three leading causes of death were cancer (26.6%), heart disease (18.0%), and cerebrovascular disease (9.0%). Among native-born VietAms the three leading causes were accidents (19.0%), self-harm (12.0%), and cancer (10.4%). For every leading cause of death, VietAms exhibited lower mortality compared to both aggregated Asians and NHWs. Over the course of the study period, VietAms witnessed an increase in mortality in every leading cause. This effect was mostly driven by foreign-born, male VietAms. Conclusions and relevance While VietAms have lower overall mortality from leading causes of death compared to aggregated Asians and NHWs, these advantages have eroded markedly between 2005 and 2020. These data emphasize the importance of racial disaggregation in the reporting of public health measures.

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Association of Acculturation with Cardiovascular Risk Factors in Asian-American Subgroups

Cited by 10 publications

References 33 publications

Cardiometabolic Health in Asian American Children

Cardiometabolic Health in Asian American Children

Social Determinants of Cardiovascular Risk Factors Among Asian American Subgroups

Leading causes of death in Vietnamese Americans: An ecological study based on national death records from 2005–2020

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