Among Asian American subgroups in the United States, heterogeneous trends in mortality from cardiovascular disease and cerebrovascular disease have been observed. These are the findings of a long, retrospective study published in the journal Circulation: Cardiovascular Quality and Outcomes.

The researchers sought to identify cardiovascular disease and cerebrovascular disease mortality trends among subgroups of Asian American individuals. They calculated age-standardized mortality rates via use of direct standardization by sex, disaggregated Asian subgroup, and underlying cause of death for each year in the study period. The 2000 US standard population was used for age adjustment.

Age-standardized mortality rates; average annual percent change in age-standardized mortality rates computed by regression; and proportional mortality ratios of ischemic heart disease (IHD), heart failure (HF), and cerebrovascular disease were calculated by sex among non-Hispanic Asian American subgroups (Chinese, Filipino, Asian Indian, Japanese, Korean, and Vietnamese individuals); non-Hispanic White; and Hispanic individuals using US death certificates from 2003 to 2017.


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Among a total of 618,004 non-Hispanic Asian American, 30,267,178 non-Hispanic White, and 2,292,257 Hispanic all-cause deaths, the findings were as follows: (1) age-standardized mortality rates from IHD decreased significantly in all subgroups of Asian American women, as well as in non-Hispanic White and Hispanic women; (2) age-standardized mortality rates from IHD also decreased significantly in Chinese, Filipino, Japanese, and Korean men, as well as in non-Hispanic White and Hispanic women; and (3) age-standardized mortality rates from IHD remained stagnant in Asian Indian and Vietnamese men.

The highest 2017 age-standardized mortality rates from IHD reported among Asian American decedents were seen in Asian Indian men (133 per 100,000) and Asian Indian women (77 per 100,000).

Age-standardized mortality rates from HF remained stagnant in Chinese, Korean, and non-Hispanic White women, as well as in Chinese and Vietnamese men. In contrast, age-standardized mortality rates from HF increased significantly in both men and women in Filipino, Asian, Indian, and Japanese individuals; in Vietnamese women; and in Korean men. The highest 2017 age-standardized mortality rates from HF among Asian American decedents were observed in Asian Indian men (15 per 100,000) and Asian Indian women (14 per 100,000).

Age-standardized mortality rates from cerebrovascular disease decreased among Chinese, Filipino, and Japanese men and women from 2003 to 2017, whereas the rates remained stagnant among Asian Indian, Korean, and Vietnamese men and women. The highest 2017 age-standardized mortality rates from cerebrovascular disease reported in Asian American subgroups were among Vietnamese men (47 per 100,000) and Vietnamese women (46 per 100,000).

Limitations of the current study include the fact that the potential exists for miscoding of ICD-10 code for cause of death on death certificates. Further, the clinical syndrome of HF represents a mode of death that may be due to IHD, hypertension, diabetes, or other disorders as the underlying cause, which could not be captured in the current analysis. Thus, the study might have underestimated HF-associated mortality.

“There was heterogeneity in cardiovascular and cerebrovascular mortality among Asian American subgroups, with stagnant or increasing mortality trends in several subgroups between 2003 and 2017,” the researchers concluded.

Disclosure: None of the study authors has declared affiliations with biotech, pharmaceutical, and/or device companies.  

Reference  

Shah NS, Xi K, Kapphahn KI, et al. Cardiovascular and cerebrovascular disease mortality in Asian American subgroups. Circ Cardiovasc Qual Outcomes. Published online May 15, 2022. doi:10.1161/CIRCOUTCOMES.121.008651