Abstract
Background/Aims Asian-Indians (AIs) have disproportionately higher rates of cardiovascular disease (CVD) than most racial/ethnic groups. We evaluated clinical risk factors including diabetes mellitus (DM), hypertension (HTN), and dyslipidemia in AI men compared with non-Hispanic white (NHW) men enrolled in the California Men’s Health Study (CMHS).
Methods Analyses included 23,360 CMHS participants (AIs = 229, NHWs = 23,131) from Kaiser Permanente Southern California. ICD-9 diagnoses of DM, HTN or dyslipidemia were captured from the medical record. We defined pharmacotherapy with a prescription of 30+ days supply filled between 1/1/03 and 12/31/10. Risk factor control was measured with lab values and blood pressures obtained between 1/1/08 and 12/31/10.
Results No differences between AI and NHW men were found for age (mean = 58 years), however, AIs had higher educational attainment (83% (191/229) versus 51% (11903/23131) with a college degree). AIs were more often diagnosed with DM (39% (89/229) versus 19% (4352/23131), P <.001) and dyslipidemia (75% (171/229) versus 65% (14942/23131), P <.05). Similar percentages of HTN were found in both groups (62% (143/229) versus 58% (13486/23131). CVD clinical risk factors tended to cluster in the AIs, such that among men with HTN, AI men more often had all three diagnoses compared to NHW men (50% (72/143) versus 26% (3528/13486), P <0.001). We observed similar findings among men with dyslipidemia (42% (72/171) versus 24% (3528/14942); P <.001). Overall, 95% of men with DM and 80% with HTN received pharmacotherapy. AI men with dyslipidemia were likely to be prescribed medication compared to NHW (148/229) versus 75% (13486/23131), P <.05). Among men with DM, there were no differences in mean A1c levels, however, AIs more frequently had A1c levels of 7+ (uncontrolled) (45% (34/76) versus 36% (1,284/3592), P = .11). Among men with HTN, the mean systolic and diastolic values were similar. Mean LDL levels were lower among AIs (113 versus 120, P <.0001). No differences were found for HDL or triglyceride values.
Conclusions Compared with NHW men, AI men more often were diagnosed with diabetes and dyslipidemia, and clustering of CVD risk factors was more prevalent. Nevertheless, in this insured population, treatment and control of clinical CVD risk factors was similar in both groups.
