Heterogeneity in the prevalence of premature hypertension among Asian American populations compared with white individuals: A National Health Interview Survey study

Sina Kianoush; Mahmoud Al Rifai; Anwar T Merchant; Xiaoming Jia; Zainab Samad; Aneil Bhalla; Ayesha Khan; Dongshan Zhu; Salim Virani

doi:10.1016/j.ijcrp.2022.200147

Heterogeneity in the prevalence of premature hypertension among Asian American populations compared with white individuals: A National Health Interview Survey study

Int J Cardiol Cardiovasc Risk Prev. 2022 Aug 18:14:200147. doi: 10.1016/j.ijcrp.2022.200147. eCollection 2022 Sep.

Authors

Sina Kianoush¹, Mahmoud Al Rifai¹, Anwar T Merchant², Xiaoming Jia¹, Zainab Samad³, Aneil Bhalla⁴, Ayesha Khan³, Dongshan Zhu⁵, Salim Virani^{1

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Affiliations

¹ Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
² Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, USA.
³ Department of Medicine, Aga Khan University, Karachi, Pakistan Aga Khan University, Karachi, Pakistan.
⁴ Section of Cardiovascular Medicine, Department of Internal Medicine, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA.
⁵ Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.
⁶ Section of Cardiovascular Research, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
⁷ Health Policy, Quality & Informatics Program, Michael E. DeBakey VA Medical Center Health Services Research & Development Center for Innovations in Quality, Effectiveness, and Safety, Houston, TX, USA.
⁸ DeBakey Heart and Vascular Institute, Houston Methodist, Houston, TX, USA.

Abstract

Background: Differences in prevalence of risk factors such as hypertension may explain heterogeneity in cardiovascular risk across Asian American populations.

Methods: We used National Health Interview Survey (NHIS) data from 2006 to 2018 among White, Chinese, Asian Indian, Filipino, and 'other Asians' (Japanese, Korean, and Vietnamese). Unadjusted and adjusted odds ratios (aOR) with 95% confidence intervals were reported using logistic regression models for the association between race and self-reported premature hypertension (age <50 years old). Models were adjusted for sex, education, body mass index, smoking status, diabetes, and coronary heart disease.

Results: We studied 99,864 participants with history of hypertension (mean age, 59.3 ± 0.1; 50% women, 90% US born). Asian Indians had higher prevalence of premature hypertension (37%) compared with Filipinos (27%), 'other Asians' (26%), Whites (25%), and Chinese (21%). Compared with Whites, Chinese individuals had lower odds of premature hypertension (aOR = 0.79, 0.63-0.98), but Asian Indians had higher odds (aOR = 1.85, 1.48-2.31). Compared with Chinese, odds of premature hypertension was higher for Asian Indians (aOR = 2.39, 1.74-3.27), Filipinos (aOR = 1.53, 1.16-2.04), and 'other Asians' (OR = 1.32, 1.03-1.70; aOR = 1.59, 1.20-2.10). Overall prevalence of hypertension was lower among Asian Indians (aOR = 0.52, 0.46-0.58) and 'other Asians' (aOR = 0.74, 0.68-0.79) compared with Whites.

Conclusions: There is heterogeneity in the risk of hypertension across Asian Americans by age. Asian Indians and 'other Asians' had higher prevalence of premature hypertension and lower prevalence of overall hypertension, which may call for earlier screening for risk factors among these populations.

Keywords: Asians; Atherosclerotic cardiovascular disease, ASCVD; Behavioral Risk Factor Surveillance System, BRFSS; Body mass index, BMI; Cardiovascular disease, CVD; Centers for Disease Control and Prevention, CDC; Coronary heart disease, (CHD); Hypertension; National Health Interview Survey, NHIS; National Health and Nutrition Examination Survey, NHANES; Racial disparity.