Association of Acculturation with Cardiovascular Risk Factors in Asian-American Subgroups

Yuemeng LI; Alicia ZHU; Austin LE; Jaiveer SINGH; Latha P. PALANIAPPAN; Malathi SRINIVASAN; Nilay S. SHAH; Sally S. WONG; Tali ELFASSY; Javier VALERO-ELIZONDO; Eugene YANG

American Journal of Preventive Cardiology (Mar 2023)

Association of Acculturation with Cardiovascular Risk Factors in Asian-American Subgroups

Yuemeng LI,
Alicia ZHU,
Austin LE,
Jaiveer SINGH,
Latha P. PALANIAPPAN,
Malathi SRINIVASAN,
Nilay S. SHAH,
Sally S. WONG,
Tali ELFASSY,
Javier VALERO-ELIZONDO,
Eugene YANG

Affiliations

Yuemeng LI: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, GA, USA
Alicia ZHU: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; College of Arts and Sciences, School of Global Public Health, New York University, New York, NY, USA
Austin LE: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; Environmental Health Sciences Division, University of California, Berkeley, School of Public Health, Berkeley, CA, USA
Jaiveer SINGH: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA
Latha P. PALANIAPPAN: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
Malathi SRINIVASAN: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; Division of Primary Care and Population Health, Stanford University School of Medicine, Stanford, CA, USA
Nilay S. SHAH: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; Departments of Medicine (Cardiology) and Preventive Medicine, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
Sally S. WONG: American Heart Association, Office of Science, Medicine, and Health, Dallas, TX, USA
Tali ELFASSY: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; Department of Medicine, Division of Nephrology and Hypertension, University of Miami Miller School of Medicine, Miami, FL, USA
Javier VALERO-ELIZONDO: Division of Cardiovascular Prevention and Wellness, Department of Cardiology, Houston Methodist DeBakey Heart and Vascular Center, Houston, TX, USA
Eugene YANG: Stanford University Center for Asian Healthcare Research and Education, Stanford, CA, USA; Division of Cardiology, University of Washington School of Medicine, Seattle, WA, USA; Corresponding author at: Division of Cardiology, University of Washington, School of Medicine, 1959 NE Pacific Street, Box 356005, Seattle, WA 98195, USA, Phone: (206) 598-6819, Fax: (206) 598-0445.

Journal volume & issue: Vol. 13
p. 100437

Abstract

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Objective: This cross-sectional study aims to better understand the heterogeneous associations of acculturation level on CV risk factors among disaggregated Asian subgroups. We hypothesize that the association between acculturation level and CV risk factors will differ significantly by Asian subgroup. Methods: We used the National Health Interview Survey (NHIS), a nationally representative US survey, years 2014–18. Acculturation was defined using: (a) years in the US, (b) US citizenship status, and (c) level of English proficiency. We created an acculturation index, categorized into low vs. high (scores of 0–3 and 4, respectively). Self-reported CV risk factors included diabetes, high cholesterol, hypertension, obesity, tobacco use, and sufficient physical activity. Rao-Scott Chi Square was used to compare age-standardized, weighted prevalence of CV risk factors between Asian subgroups. We used logistic regression analysis to assess associations between acculturation and CV risk factors, stratified by Asian subgroup. Results: The study sample consisted of 6,051 adults ≥ 18 years of age (53.9% female; mean age 46.6 [SE 0.33]). The distribution by race/ethnicity was Asian Indian 26.9%, Chinese 22.8%, Filipino 18.1%, and other Asian 32.3%. The association between acculturation and CV risk factors differed by Asian subgroups. From multivariable adjusted models, high vs. low acculturation was associated with: high cholesterol amongst Asian Indian (OR=1.57, 95% CI: 1.11, 2.37) and other Asian (OR=1.48, 95% CI: 1.10, 2.01) adults, obesity amongst Filipino adults (OR= 1.62, 95% CI: 1.07, 2.45), and sufficient physical activity amongst Chinese (OR= 1.54, 95% CI: 1.09, 2.19) and Filipino adults (OR=1.58, 95% CI: 1.10, 2.27). Conclusion: This study demonstrates that acculturation is heterogeneously associated with higher prevalence of CV risk factors among Asian subgroups. More studies are needed to better understand these differences that can help to inform targeted, culturally specific interventions.

Published in American Journal of Preventive Cardiology

ISSN: 2666-6677 (Online)
Publisher: Elsevier
Country of publisher: United States
LCC subjects: Medicine: Internal medicine: Specialties of internal medicine: Diseases of the circulatory (Cardiovascular) system; Medicine: Public aspects of medicine
Website: https://www.journals.elsevier.com/american-journal-of-preventive-cardiology/

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