Disparities in Heart Disease Risk Among Asian American and Pacific Islander Communities

Recent studies reveal significant variations in cardiovascular disease (CVD) risk and associated factors within Asian American, Native Hawaiian, and Pacific Islander (AANHPI) populations. These findings were unveiled during the American Heart Association's Epidemiology and Prevention | Lifestyle and Cardiometabolic Health Scientific Sessions 2025 held in New Orleans.

Research has indicated stark differences in heart disease prevalence and stroke risk factors among various AANHPI subgroups. Notably, Native Hawaiian and Pacific Islander adults face a higher mortality rate from CVD compared to their non-Hispanic white counterparts. According to data from the U.S. Department of Health and Human Services, Native Hawaiian and Pacific Islander individuals were 10% more likely to receive a coronary heart disease diagnosis than non-Hispanic whites in 2014.

Lead researchers emphasized that AANHPI groups have often been treated as a monolithic entity in clinical research, obscuring critical differences in risk factors and disease burden. Rishi V. Parikh, a senior research analyst at Kaiser Permanente Northern California, highlighted the need for more granular studies that consider the diverse experiences and health profiles of these communities.

The PANACHE (Pacific Islander, Native Hawaiian and Asian American Cardiovascular Health Epidemiology) study examined health records from nearly 700,000 adults enrolled in large health systems in California and Hawaii from 2012 to 2022. Participants represented various subgroups, including Chinese, Filipino, Native Hawaiian, and South Asian individuals.

The analysis revealed stark contrasts in the prevalence of traditional cardiovascular risk factors among different AANHPI subgroups. For instance, high blood pressure was found in 12% of Chinese adults, compared to 30% in Filipino adults. Similarly, high cholesterol levels were recorded at 20% among Chinese adults and 33% among Filipinos. Obesity rates also varied significantly, with 11% of Vietnamese adults classified as obese, while the figure surged to 41% among Native Hawaiian and Pacific Islander populations.

Type 2 diabetes prevalence ranged from 5% in Chinese adults to 14% in Native Hawaiian and Pacific Islander adults. Smoking rates were notably higher in Native Hawaiian and Pacific Islander groups, exceeding 13%, while other AANHPI subgroups reported less than 10% smoking prevalence. Overall, AANHPI populations exhibited higher rates of Type 2 diabetes and high cholesterol when compared to non-Hispanic white adults.

Using the American Heart Association's PREVENT risk calculator, the researchers found that the 10-year predicted risk for cardiovascular events was highest among Native Hawaiian and Pacific Islander adults, with Filipino, South Asian, and other Southeast Asian populations also exhibiting elevated risk compared to non-Hispanic whites.

Experts recommend ongoing monitoring of cardiovascular risk factors such as blood pressure and cholesterol levels within AANHPI populations to facilitate early detection and prevention of heart disease. A follow-up phase of the PANACHE study aims to conduct population-based surveys to capture additional risk factors not typically recorded in electronic health records, including social determinants of health and lifestyle factors that may uniquely affect each subgroup.

Understanding the varied health profiles within AANHPI communities is essential for addressing health disparities and developing targeted cardiovascular prevention strategies. Cardiovascular disease remains a leading cause of mortality in the United States, making it crucial to identify and manage risk factors accurately across diverse population groups.