title: Cardiovascular disease mortality in Asian Americans.
abstract: BACKGROUND
  Asian Americans are a rapidly growing racial/ethnic group in the United States. Our current understanding of Asian-American cardiovascular disease mortality patterns is distorted by the aggregation of distinct subgroups.
  
  
  OBJECTIVE
  The purpose of the study was to examine heart disease and stroke mortality rates in Asian-American subgroups to determine racial/ethnic differences in cardiovascular disease mortality within the United States.
  
  
  METHODS
  We examined heart disease and stroke mortality rates for the 6 largest Asian-American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) from 2003 to 2010. U.S. death records were used to identify race/ethnicity and cause of death by International Classification of Diseases-10th revision coding. Using both U.S. Census data and death record data, standardized mortality ratios (SMRs), relative SMRs (rSMRs), and proportional mortality ratios were calculated for each sex and ethnic group relative to non-Hispanic whites (NHWs).
  
  
  RESULTS
  In this study, 10,442,034 death records were examined. Whereas NHW men and women had the highest overall mortality rates, Asian Indian men and women and Filipino men had greater proportionate mortality burden from ischemic heart disease. The proportionate mortality burden of hypertensive heart disease and cerebrovascular disease, especially hemorrhagic stroke, was higher in every Asian-American subgroup compared with NHWs.
  
  
  CONCLUSIONS
  The heterogeneity in cardiovascular disease mortality patterns among diverse Asian-American subgroups calls attention to the need for more research to help direct more specific treatment and prevention efforts, in particular with hypertension and stroke, to reduce health disparities for this growing population.
authors.affiliation: Palo Alto Medical Foundation Research Institute, Palo Alto, California.
authors.forename: Powell O
authors.initials: PO
authors.lastname: Jose
authors.affiliation: Palo Alto Medical Foundation Research Institute, Palo Alto, California.
authors.forename: Ariel T H
authors.initials: AT
authors.lastname: Frank
authors.affiliation: Stanford University School of Medicine, Stanford, California.
authors.forename: Kristopher I
authors.initials: KI
authors.lastname: Kapphahn
authors.affiliation: Stanford University School of Medicine, Stanford, California.
authors.forename: Benjamin A
authors.initials: BA
authors.lastname: Goldstein
authors.affiliation: Stanford University Shorenstein Asia-Pacific Research Center, Stanford, California.
authors.forename: Karen
authors.initials: K
authors.lastname: Eggleston
authors.affiliation: Palo Alto Medical Foundation Research Institute, Palo Alto, California.
authors.forename: Katherine G
authors.initials: KG
authors.lastname: Hastings
authors.affiliation: Stanford University School of Medicine, Stanford, California.
authors.forename: Mark R
authors.initials: MR
authors.lastname: Cullen
authors.affiliation: Palo Alto Medical Foundation Research Institute, Palo Alto, California. Electronic address: lathap@pamfri.org.
authors.forename: Latha P
authors.initials: LP
authors.lastname: Palaniappan
mesh_terms: D017677:Age Distribution; D000368:Aged; D001213:Asian / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000401:mortality*; D003644:Death Certificates; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
keywords: cardiovascular disease; disparities; ethnicity; etiology; stroke