Abstract
Background/Aims Asian Americans are a rapidly growing minority population in the US. Higher rates of coronary heart disease (CHD) have been found for some Asian American subgroups, especially Asian Indians and Filipinos. Hypertension (HTN) is a major CHD risk factor, but rates of HTN among Asian American subgroups are unknown largely due to either underrepresentation or aggregation of Asian American subgroups in epidemiologic surveys.
Methods We examined prevalence rates of HTN across Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) compared to the Non-Hispanic White (NHW) population within a large, diverse, mixed payer ambulatory care setting in Northern California; all patients were insured. Electronic health records of 216,768 patients over 18 years of age who had at least two primary care visits from 2008–2010 were used for analysis (65% NHW, 13% Asian Indian, 14% Chinese, 3% Filipino, 2% Japanese, 1% Korean, and 2% Vietnamese). Prevalence rates were age- and sex-adjusted to the NHW population. The following criteria was used to define HTN: two separate non-emergent office visit blood pressure measurements ≥140/90mm Hg, ICD-9 coding for hypertension (401.X), or use of any anti-hypertensive medications. Prevalence rates of HTN for each group are presented with 99% confidence limits.
Results Age- and sex-adjusted hypertension rates were lower for aggregated Asian Americans (34.9%, 99% CI 34.5–35.3%) compared to NHW (38.9%, 38.6–39.2%). Filipinos, however, had much higher HTN rates (51.2%, 50.7–53.2%) compared to NHWs. Adjusted HTN rates were lower among the majority of Asian subgroups including Chinese (29.8%, 29.1–30.4%), Koreans (30.7%, 28.0–33.5%), Vietnamese (30.8%, 28.7–32.8%), and Asian Indians (36.9%, 35.9–37.8%), compared to NHWs. Japanese had similar HTN rates as NHWs (38.2%, 36.5–39.9%).
Conclusions There is substantial heterogeneity in HTN prevalence among Asian American subgroups, with Filipino Americans exhibiting the highest rates of HTN. This analysis underscores the need to study Asian American subgroups separately to avoid masking the significant heterogeneity in cardiovascular risk factors.
