Hypertension Prevalence, Treatment, and Related Behaviors Among Asian Americans: An Examination by Method of Measurement and Disaggregated Subgroups

Jung, Mary; Lee, Sunmin; Thomas, Stephen B.; Juon, Hee‐Soon

doi:10.1007/s40615-018-00557-6

Cited by 17 publications

(12 citation statements)

References 30 publications

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“…This is compared to data from another study that found among Asian Americans in Los Angeles County, 32.9% ages 50–64 and 59.6% ages 65 + had hypertension [ 42 ]. Although the prevalence of hypertension in our sample seems higher than a previous age-adjusted estimate of hypertension of 27.5% among Chinese, Korean, and Vietnamese adult participants 18 years-old and older in the Washington-Baltimore Metropolitan Area, the prevalence of hypertension in our study seems similar to other research on middle-aged and older Asian Americans [ 7 , 43 ].…”

Section: Discussionsupporting

confidence: 60%

“…These findings coincide with other studies finding that older Asian Americans and men are more likely to have hypertension [ 6 , 42 , 46 ]. Further, studies have found Korean Americans have higher prevalence of hypertension than Chinese Americans [ 7 , 47 ]. Our finding that being married/cohabitating was associated with higher likelihood of diagnosed hypertension contradicts prior studies of this topic [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

“…Study participants provided three blood pressure measurements obtained by trained staff using the Omron blood pressure monitor (Model BP710). We calculated systolic and diastolic blood pressure by taking the average of the second and third measurements according to recommended practice [ 7 , 33 ]. Blood pressure measurements were used to indicate hypertension using the guidelines recommended by the Joint National Committee on Prevention, Detection, Evaluation and Treatment of High Blood Pressure (hypertension is present when systolic blood pressure is greater than or equal to 140 mm Hg or when diastolic blood pressure is greater than or equal to 90 mm Hg) [ 34 ].…”

Section: Methodsmentioning

confidence: 99%

“…For example, one study using data from the National Health and Nutrition Examination Survey (NHANES) found that Asian Americans were at 41% greater odds of having undiagnosed hypertension compared to white Americans [ 6 ]. Another community-based study found that hypertension prevalence determined by direct blood pressure measurement among Chinese, Korean, and Vietnamese Americans was 27.5%, which was higher than the NHANES estimate of 24.9% among Asian Americans based solely on self-reported diagnosis by a medical professional [ 7 ]. Together, these findings indicate that for reasons largely unknown, Asian Americans are more likely to be unaware that they have hypertension and are therefore at increased risk of untreated hypertension leading to more severe morbidity and mortality.…”

Section: Introductionmentioning

confidence: 99%

“…Since some Asian populations including Koreans develop hypertension at younger ages than average in the U.S. [ 18 ], it is possible that those with undiagnosed hypertension are younger in age. Differences in hypertension status may exist by gender or country of origin [ 7 ]. Socioeconomic status likely plays a major role in undiagnosed hypertension among Asian Americans [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Correlates of Undiagnosed Hypertension Among Chinese and Korean American Immigrants

2022

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Asian Americans are more likely to be unaware that they have hypertension compared to non-Hispanic white Americans, despite having higher risk of hypertension at lower body-mass indices. Furthermore, immigrants are more likely than their United States (U.S.)-born counterparts to have undiagnosed hypertension, placing them at greater risk of subsequent morbidity and mortality. This study examines the social determinants of undiagnosed hypertension among Asian American immigrants. Using a study of foreign-born Chinese and Korean Americans between the ages of 50–75 years-old recruited from physicians’ clinics in the Baltimore-Washington DC Metropolitan Area (n = 355), we used blood pressure readings measured by trained staff members, self-reported diagnosis by a medical professional, and self-reported hypertension medication use to determine hypertension status—whether patients were non-hypertensive, had diagnosed hypertension, or had undiagnosed hypertension. Using multinomial logistic regression, we examined how demographic, socioeconomic, and immigration-related factors were associated with hypertension status. Results indicated that older age, male gender, Korean subgroup, and marital status were associated with having diagnosed hypertension compared to being non-hypertensive. Lack of health insurance was the strongest predictor of having undiagnosed hypertension compared to being non-hypertensive. Acculturation variables had no strong associations with hypertension status. We then explored correlates of health insurance status for Chinese and Korean American immigrants. Those without health insurance were more likely to have lower income and to be not currently employed. Our findings point to the importance of increasing health insurance access for Asian American immigrant groups to ensure that hypertension is not left undiagnosed and untreated.

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Section: Discussionsupporting

confidence: 60%

Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Correlates of Undiagnosed Hypertension Among Chinese and Korean American Immigrants

2022

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Racial and Ethnic Differences in Amyloid PET Positivity in Individuals With Mild Cognitive Impairment or Dementia

et al. 2022

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ImportanceRacial and ethnic groups with higher rates of clinical Alzheimer disease (AD) are underrepresented in studies of AD biomarkers, including amyloid positron emission tomography (PET).ObjectiveTo compare amyloid PET positivity among a diverse cohort of individuals with mild cognitive impairment (MCI) or dementia.Design, Setting, and ParticipantsSecondary analysis of the Imaging Dementia–Evidence for Amyloid Scanning (IDEAS), a single-arm multisite cohort study of Medicare beneficiaries who met appropriate-use criteria for amyloid PET imaging between February 2016 and September 2017 with follow-up through January 2018. Data were analyzed between April 2020 and January 2022. This study used 2 approaches: the McNemar test to compare amyloid PET positivity proportions between matched racial and ethnic groups and multivariable logistic regression to assess the odds of having a positive amyloid PET scan. IDEAS enrolled participants at 595 US dementia specialist practices. A total of 21 949 were enrolled and 4842 (22%) were excluded from the present analysis due to protocol violations, not receiving an amyloid PET scan, not having a positive or negative scan, or because of small numbers in some subgroups.ExposuresIn the IDEAS study, participants underwent a single amyloid PET scan.Main Outcomes and MeasuresThe main outcomes were amyloid PET positivity proportions and odds.ResultsData from 17 107 individuals (321 Asian, 635 Black, 829 Hispanic, and 15 322 White) with MCI or dementia and amyloid PET were analyzed between April 2020 and January 2022. The median (range) age of participants was 75 (65-105) years; 8769 participants (51.3%) were female and 8338 (48.7%) were male. In the optimal 1:1 matching analysis (n = 3154), White participants had a greater proportion of positive amyloid PET scans compared with Asian participants (181 of 313; 57.8%; 95% CI, 52.3-63.2 vs 142 of 313; 45.4%; 95% CI, 39.9-50.9, respectively; P = .001) and Hispanic participants (482 of 780; 61.8%; 95% CI, 58.3-65.1 vs 425 of 780; 54.5%; 95% CI, 51.0-58.0, respectively; P = .003) but not Black participants (359 of 615; 58.4%; 95% CI, 54.4-62.2 vs 333 of 615; 54.1%; 95% CI, 50.2-58.0, respectively; P = .13). In the adjusted model, the odds of having a positive amyloid PET scan were lower for Asian participants (odds ratio [OR], 0.47; 95% CI, 0.37-0.59; P &lt; .001), Black participants (OR, 0.71; 95% CI, 0.60-0.84; P &lt; .001), and Hispanic participants (OR, 0.68; 95% CI, 0.59-0.79; P &lt; .001) compared with White participants.Conclusions and RelevanceRacial and ethnic differences found in amyloid PET positivity among individuals with MCI and dementia in this study may indicate differences in underlying etiology of cognitive impairment and guide future treatment and prevention approaches.

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Association of amyloid and cardiovascular risk with cognition: Findings from KBASE

Chaudhuri,

Dempsey,

Huang

et al. 2024

Alzheimer's & Dementia

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BACKGROUNDLimited research has explored the effect of cardiovascular risk and amyloid interplay on cognitive decline in East Asians.METHODSVascular burden was quantified using Framingham's General Cardiovascular Risk Score (FRS) in 526 Korean Brain Aging Study (KBASE) participants. Cognitive differences in groups stratified by FRS and amyloid positivity were assessed at baseline and longitudinally.RESULTSBaseline analyses revealed that amyloid‐negative (Aβ–) cognitively normal (CN) individuals with high FRS had lower cognition compared to Aβ– CN individuals with low FRS (p < 0.0001). Longitudinally, amyloid pathology predominantly drove cognitive decline, while FRS alone had negligible effects on cognition in CN and mild cognitive impairment (MCI) groups.CONCLUSIONOur findings indicate that managing vascular risk may be crucial in preserving cognition in Aβ– individuals early on and before the clinical manifestation of dementia. Within the CN and MCI groups, irrespective of FRS status, amyloid‐positive individuals had worse cognitive performance than Aβ– individuals.Highlights Vascular risk significantly affects cognition in amyloid‐negative older Koreans. Amyloid‐negative CN older adults with high vascular risk had lower baseline cognition. Amyloid pathology drives cognitive decline in CN and MCI, regardless of vascular risk. The study underscores the impact of vascular health on the AD disease spectrum.

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Hypertension Prevalence, Treatment, and Related Behaviors Among Asian Americans: An Examination by Method of Measurement and Disaggregated Subgroups

Cited by 17 publications

References 30 publications

Correlates of Undiagnosed Hypertension Among Chinese and Korean American Immigrants

Correlates of Undiagnosed Hypertension Among Chinese and Korean American Immigrants

Racial and Ethnic Differences in Amyloid PET Positivity in Individuals With Mild Cognitive Impairment or Dementia

Association of amyloid and cardiovascular risk with cognition: Findings from KBASE

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