Investigating heart disease mortality in Asian American populations

Mortality rates for ischemic heart disease varied more between different Asian American populations than had been previously reported, according to a Northwestern Medicine study published in JAMA Internal Medicine.

"Ischemic heart disease deaths are preventable. The implication is that we need to be starting at a much younger age to address cardiovascular risk factors," said Nilay Shah, assistant professor of Medicine in the Division of Cardiology, of Preventive Medicine in the Division of Epidemiology and senior author of the study.

Previous studies investigating mortality rates for ischemic heart disease (IHD), when the arteries are narrowed and less blood and oxygen reach the heart, have revealed noticeable disparities between different racial and ethnic populations in the U.S.

Previous studies, however, have frequently aggregated Asian American subpopulations into one category, leading to inaccurate data of premature IHD mortality rates and risk factors for these patient groups.

In the current study, investigators examined and compared age-specific proportional mortality from IHD among Asian American subgroups that occurred between 2018 and 2020. The investigators analyzed IHD mortality rates from The Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiologic Research (CDC WONDER), which includes data on deaths from all causes and IHD as the underlying cause of death.

Of all the deaths that occurred among racial and ethnic groups, 10.4% were due to IHD in non-Hispanic white women, compared with 13.2% due to IHD in Asian Indian women and 11.9% due to IHD in Chinese women.

Most notably, the proportion of deaths due to IHD in Asian Indian men aged 45 to 64 years was significantly higher compared to non-Hispanic white men in the same age group—21.2% versus 15.1%.

"What that tells me is that heart disease events are happening at younger ages in this group. The reason I found it so striking was because it's such a high proportion of the number of deaths that occur and most of those are probably preventable," Shah said.

IHD also accounted for 14.6% of deaths in non-Hispanic white men compared to 18.7% in Asian Indian men and 15.2% in Filipino men. In contrast, and Korean and Vietnamese men experienced significantly lower proportional mortality from IHD; 12.4% and 12.2%, respectively.

"There are likely interventions, both at the individual level like during interactions between patients and their doctors, and at the population level like policy and community programs that are both equally important to prevent this burden that we see," Shah said.