Author + information
- Ashim B. Hajra,
- Yan Li,
- Stanton Siu,
- Natalia Udaltsova,
- Mary Anne Armstrong,
- Gary Friedman and
- Arthur Klatsky
Although South Asians have recently become a more substantial proportion of the U.S. population, prospective data investigating their risk for coronary artery disease (CAD) remain sparse. To further explore the CAD risk of South Asian Americans we performed a new cohort study with long-term follow-up.
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%) Asian Americans including 5,951 Chinese, 1,676 Japanese, 4,236 Filipinos, 689 South Asians (mostly Asian Indians), and 896 Other Asians. 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. These models yielded hazard ratios (HR) and 95% confidence intervals (CI).
With whites as referent the adjusted HR (CI) for all Asians was 1.0 (0.9-1.0). In a separate model the HR (CI)s were: Chinese = 0.8 (0.7-0.9, p<0.001), Japanese = 0.9 (0.7-1.1), Filipinos = 1.2 (1.0-1.3, p=0.02); South Asians = 2.4 (1.9-3.2, p<0.001), and Other Asians = 0.8 (0.5-1.1). Increased risk of South Asians was present in multiple strata, with the largest HRs in men, younger persons, heavy smokers, and persons with CAD events in the first 10 years of follow-up. Addition of blood pressure, total cholesterol, blood glucose, or leukocyte count to the models had minimal effect on the magnitude of the increased South Asian risk. South Asians were at higher risk (p<0.001) in separate models with blacks or Hispanics as referent. In models limited to Asians, South Asians had higher HRs than each other Asian group (p<0.001 for each).
(1) Disparities in CAD risk among Asian American ethnic groups include a substantially increased risk of South Asians, compared to whites, blacks, Hispanics or to other Asian American ethnic groups. (2) These data mandate further investigation into causes and public health measures targeted at reducing CAD risk of South Asians.
Poster Sessions, Expo North
Sunday, March 10, 2013, 9:45 a.m.-10:30 a.m.
Session Title: Prevention: Cardiovascular Risk around the Globe
Abstract Category: 24. Prevention: Clinical
Presentation Number: 1187-18
- 2013 American College of Cardiology Foundation