Abstract P231: Asian American Disparities in Risk of Coronary Artery Disease
INTRODUCTION: The number of Asian Americans (Asians) has increased substantially in recent decades, yet prospective data about their risk for coronary artery disease (CAD) remain sparse. We hypothesized significant disparities of CAD risk among Asians.
METHODS: A multi-ethnic population of 126,088 adults in Northern California supplied baseline data from 1978-1985. Self-classified ethnicity yielded 13,448 (10.6%) Asians including 5,951 Chinese (CH), 1,676 Japanese (JA), 4,236 Filipinos (FI), 689 South Asians (SA) (mostly Asian Indians), and 896 Other Asians (OA). Persons with incident CAD hospitalizations through 2008 numbered 7,658, including 700 Asians. Analyses used Cox proportional hazards models which included age, sex, ethnicity, smoking, alcohol, body mass index, education, marital status, and a composite of possible baseline CAD history/symptoms/risk factors. Models with various referents enabled comparison of all Asian groups to each other as well as to whites, blacks, or Hispanics. These models yielded hazard ratios (HR) and 95% confidence intervals (CI).
RESULTS: With whites as referent the adjusted HR (CI) for all Asians was 1.0 (0.9-1.0). In a separate model the HRs were: CH = 0.8 (0.7-0.9, p<0.001), JA = 0.9 (0.7-1.1), FI = 1.2 (1.0-1.3, p=0.02); SA = 2.4 (1.9-3.2, p<0.001), and OA = 0.8 (0.5-1.1). Addition of blood pressure, total cholesterol, blood glucose, or leukocyte count to the models had minimal effect on the magnitude of these HRs. SAs were at substantially higher risk than whites, blacks, Hispanics, and each other Asian group with HRs ranging from 2.2 to 3.3 (all p values < 0.001). FI were at a higher risk than all groups except for SA, with HRs ranging from 1.3-1.7 (all p values <0.04). The table gives HRs for Asian groups vs. CH.
CONCLUSION: Disparities in CAD risk among Asian American ethnic groups are marked, indicating the need to study disease outcomes separately for the groups. The high risks of SAs and FIs mandate further investigation into causes and targeted public health measures.
- © 2013 by American Heart Association, Inc.