Top Things to Know: Epidemiology of Diabetes and Atherosclerotic CV Disease Among Asian American Adults – Implications, Management, and Future Directions
Prepared by Sally S. Wong, PhD, RD, CDN, FAHA, National Director, Science & Medicine
- According to the 2020 US Census, the Asian population makes up 7.2% of the US population, with the largest subgroups represented by Chinese (4.1 million), Asian Indians (4 million), Filipinos (2.9 million), Vietnamese (1.8 million), Korean (1.5 million), and Japanese (0.8 million), accounting for 87% of the AsA population.
- The many complex immigration factors, income variation, and variable sociodemographic characteristics collectively influence the social determinants of health in this population, which may in turn impact the different patterns of T2D and ASCVD risk observed among AsA adults.
- Diabetes epidemiology among AsA adults and its subgroups has primarily consisted of prevalence estimates using data from health systems, a handful of cohort studies, and a few state-level and national surveillance surveys. Unfortunately, many of these data sources include only aggregated data combining all AsA adults.
- Asian subgroups differ substantially in their coronary artery disease (CAD) risk. Existing data collectively suggest that there is a wide variation of the prevalence of CAD in AsA subgroups with South Asian adults bearing the highest risk compared to East Asian adults.
- A growing number of studies focused on non-European ancestry cohorts have uncovered genetic variants that appear to be unique to ASCVD risk in specific Asian ancestries.
- In order to provide culturally appropriate intervention strategies, this statement attempts to divide Asian cuisines into three main regions and outline the key highlights from each region, as well as weaknesses and diet recommendations. Understanding the characteristics of diets in these Asia regions can help to better understand the food types that make up each region, which would be helpful with menu planning and improve dietary adherence.
- Community-based efforts can have the potential to educate AsA on the health risks behaviors associated with tobacco product use. Central to these efforts are considerations of family characteristics, social networks and community resources and supports.
- Racial and ethnic minorities experience more negative patterns of sleep duration and more sleep disorders than their white counterparts which may further increase their ASCVD risk. Minimal data are available regarding sleep disorders in AsA adults.
- This statement highlights the challenges to provide evidence-based recommendations included the limited data on AsA adults in risk prediction models, national surveillance surveys and clinical trials, leading to significant research disparities in this population.
- Finally, this statement outlines the specific areas that public health and health care professionals should pay attention to for the prevention and management of T2D and ASCVD risk among AsA subgroups.
Citation
Kwan TW, Wong SS, Hong Y, Kanaya AM, Khan SS, Hayman LL, Shah SH, Welty FK, Deedwania PC, Khaliq A, Palaniappan LP; on behalf of the American Heart Association Council on Epidemiology and Prevention; Council on Lifestyle and Cardiometabolic Health; Council on Arteriosclerosis, Thrombosis and Vascular Biology; Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; and Council on Genomic and Precision Medicine. Epidemiology of diabetes and atherosclerotic cardiovascular disease among Asian American adults: implications,management, and future directions: a scientific statement from the American Heart Association [published online ahead of print May 8, 2023]. Circulation. doi: 10.1161/CIR.0000000000001145