--- title: "Geographic variation in CVD mortality in Asian Am subgroups. | Sutter Health" description: "Cerebrovascular disease mortality demonstrated substantial geographical differences by Asian American subgroup." url: "https://www.sutterhealth.org/research/publications/geographic-variation-cvd-mortality-asian-ams-1055312318" --- 1. [Home](https://www.sutterhealth.org/) / 2. [Research](https://www.sutterhealth.org/research) / 3. [Research publications](https://www.sutterhealth.org/research/publications) / 4. Geographic variation in CVD mortality in Asian Am subgroups. # Geographic variations in cardiovascular disease mortality among Asian American subgroups, 2003-2011. Pu J, Hastings KG, Boothroyd D, Jose PO, Chung S, Shah JB, Cullen MR, Palaniappan LP, & Rehkopf DH. _J Am Heart Assoc. 6(7). pii: e005597. doi: 10.1161/JAHA.117.005597._ 2017-07-12 ## Abstract BACKGROUND: There are well-documented geographical differences in cardiovascular disease (CVD) mortality for non-Hispanic whites. However, it remains unknown whether similar geographical variation in CVD mortality exists for Asian American subgroups. This study aims to examine geographical differences in CVD mortality among Asian American subgroups living in the United States and whether they are consistent with geographical differences observed among non-Hispanic whites. METHODS AND RESULTS: Using US death records from 2003 to 2011 (n=3 897 040 CVD deaths), age-adjusted CVD mortality rates per 100 000 population and age-adjusted mortality rate ratios were calculated for the 6 largest Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) and compared with non-Hispanic whites. There were consistently lower mortality rates for all Asian American subgroups compared with non-Hispanic whites across divisions for CVD mortality and ischemic heart disease mortality. However, cerebrovascular disease mortality demonstrated substantial geographical differences by Asian American subgroup. There were a number of regional divisions where certain Asian American subgroups (Filipino and Japanese men, Korean and Vietnamese men and women) possessed no mortality advantage compared with non-Hispanic whites. The most striking geographical variation was with Filipino men (age-adjusted mortality rate ratio=1.18; 95% CI, 1.14-1.24) and Japanese men (age-adjusted mortality rate ratio=1.05; 95% CI: 1.00-1.11) in the Pacific division who had significantly higher cerebrovascular mortality than non-Hispanic whites. CONCLUSIONS: There was substantial geographical variation in Asian American subgroup mortality for cerebrovascular disease when compared with non-Hispanic whites. It deserves increased attention to prioritize prevention and treatment in the Pacific division where approximately 80% of Filipinos CVD deaths and 90% of Japanese CVD deaths occur in the United States. [PubMed abstract](https://www.ncbi.nlm.nih.gov/pubmed/28701306) ## Research topics - [Cardiovascular Diseases](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cardiovascular+Diseases%5C%22%22) - [Cerebrovascular Disorders](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Cerebrovascular+Disorders%5C%22%22) - [Health Disparities](https://www.sutterhealth.org/research-search-results?query=%22%5C%22Health+Disparities%5C%22%22) ## Related publications [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) - Publication ### [Racial/ethnic differences in dyslipidemia patterns.](https://www.sutterhealth.org/research/publications/racial-ethnic-differences-in-dyslipidemia-patterns-1055312616) Frank AT, Zhao B, Jose PO, Azar KM, Fortmann SP, Palaniappan LP. Circulation. 129(5):570-9. doi: 10.1161/CIRCULATIONAHA.113.005757. Epub 2013 Nov 5. 2014 Feb 04 - Publication ### [Moderating effects of patient characteristics on the impact of financial incentives.](https://www.sutterhealth.org/research/publications/effects-of-pt-characteristics-on-financial-incentives-1055312755) Rosenthal MB, Troxel AB, Volpp KG, Stewart WF, Sequist TD, Jones JB, Hirsch AG, Hoffer K, Zhu J, Wang W, Hodlofski A, Finnerty D, Huang JJ, Asch DA. Med Care Res Rev. 76(1):56-72. doi: 10.1177/1077558717707313. Epub 2017 May 8. 2019 Feb 01 - Publication ### [Disparities in blood pressure control within a community-based provider network: an exploratory analysis.](https://www.sutterhealth.org/research/publications/disparities-in-blood-pressure-control-1055312715) Romanelli RJ1, Schiro TA, Jukes T, Wong KS, Ishisaka DY. Ann Pharmacother. 45(12):1473-82. doi: 10.1345/aph.1Q523. Epub 2011 Dec 6. 2011 Dec 01 - Publication ### [Dyslipidemia in special ethnic populations.](https://www.sutterhealth.org/research/publications/dyslipidemia-special-ethnic-populations-1055312482) Pu J, Romanelli R, Zhao B, Azar KM, Hastings KG, Nimbal V, Fortmann SP, Palaniappan LP. Endocrinol Metab Clin North Am. 45(1):205-16. doi: 10.1016/j.ecl.2015.09.013 2016 Mar 01 - Publication ### [Disparities in adherence to and persistence with antihypertensive regimens: an exploratory analysis from a community-based provider network.](https://www.sutterhealth.org/research/publications/disparities-in-adherence-to-anti-htn-regimens-1055312629) Ishisaka DY, Jukes T, Romanelli RJ, Wong KS, Schiro TA. J Am Soc Hypertens. 6(3):201-9. doi: 10.1016/j.jash.2012.02.004. 2012 May 01 [View all publications](https://www.sutterhealth.org/research-search-results?verticalKey=research_publication) ```json {"@context":"https://schema.org","@type":"MedicalOrganization","name":"Sutter Health","@id":"https://www.sutterhealth.org/#medicalorganization","url":"https://www.sutterhealth.org","logo":"https://www.sutterhealth.org/static/images/sutter-health-logo.svg","address":{"@type":"PostalAddress","streetAddress":"2200 River Plaza Drive","addressLocality":"Sacramento","addressRegion":"CA","postalCode":"95833","addressCountry":"US"},"areaServed":{"@type":"AdministrativeArea","name":"California"},"sameAs":["https://www.facebook.com/SutterHealth","https://www.instagram.com/sutterhealth/","https://x.com/SutterHealth","https://www.youtube.com/sutterhealth","https://www.linkedin.com/company/sutter-health","https://en.wikipedia.org/wiki/Sutter_Health"]} ``` ```json {"@context":"https://schema.org","@type":"BreadcrumbList","@id":"https://www.sutterhealth.org/research/publications/geographic-variation-cvd-mortality-asian-ams-1055312318#breadcrumblist","itemListElement":[{"@type":"ListItem","position":1,"name":"Home","item":"https://www.sutterhealth.org/"},{"@type":"ListItem","position":2,"name":"Research","item":"https://www.sutterhealth.org/research"},{"@type":"ListItem","position":3,"name":"Research publications","item":"https://www.sutterhealth.org/research/publications"},{"@type":"ListItem","position":4,"name":"Geographic variation in CVD mortality in Asian Am subgroups."}]} ``` ```json {"@context":"https://schema.org","@type":"MedicalScholarlyArticle","@id":"https://www.sutterhealth.org/research/publications/geographic-variation-cvd-mortality-asian-ams-1055312318#medicalscholarlyarticle","name":"Geographic variations in cardiovascular disease mortality among Asian American subgroups, 2003-2011.","headline":"Geographic variation in CVD mortality in Asian Am subgroups.","abstract":"BACKGROUND: There are well-documented geographical differences in cardiovascular disease (CVD) mortality for non-Hispanic whites. However, it remains unknown whether similar geographical variation in CVD mortality exists for Asian American subgroups. This study aims to examine geographical differences in CVD mortality among Asian American subgroups living in the United States and whether they are consistent with geographical differences observed among non-Hispanic whites. METHODS AND RESULTS: Using US death records from 2003 to 2011 (n=3 897 040 CVD deaths), age-adjusted CVD mortality rates per 100 000 population and age-adjusted mortality rate ratios were calculated for the 6 largest Asian American subgroups (Asian Indian, Chinese, Filipino, Japanese, Korean, and Vietnamese) and compared with non-Hispanic whites. There were consistently lower mortality rates for all Asian American subgroups compared with non-Hispanic whites across divisions for CVD mortality and ischemic heart disease mortality. However, cerebrovascular disease mortality demonstrated substantial geographical differences by Asian American subgroup. There were a number of regional divisions where certain Asian American subgroups (Filipino and Japanese men, Korean and Vietnamese men and women) possessed no mortality advantage compared with non-Hispanic whites. The most striking geographical variation was with Filipino men (age-adjusted mortality rate ratio=1.18; 95% CI, 1.14-1.24) and Japanese men (age-adjusted mortality rate ratio=1.05; 95% CI: 1.00-1.11) in the Pacific division who had significantly higher cerebrovascular mortality than non-Hispanic whites. CONCLUSIONS: There was substantial geographical variation in Asian American subgroup mortality for cerebrovascular disease when compared with non-Hispanic whites. It deserves increased attention to prioritize prevention and treatment in the Pacific division where approximately 80% of Filipinos CVD deaths and 90% of Japanese CVD deaths occur in the United States.","description":"Cerebrovascular disease mortality demonstrated substantial geographical differences by Asian American subgroup.","keywords":["Cardiovascular Diseases","Cerebrovascular Disorders","Health Disparities"],"datePublished":"2017-07-12","url":"https://www.sutterhealth.org/research/publications/geographic-variation-cvd-mortality-asian-ams-1055312318","inLanguage":"en-US","identifier":[{"@type":"PropertyValue","propertyID":"PMID","value":"28701306"},{"@type":"PropertyValue","propertyID":"DOI","value":"10.1161/JAHA.117.005597"}],"sameAs":["https://pubmed.ncbi.nlm.nih.gov/28701306/","https://doi.org/10.1161/JAHA.117.005597"],"isPartOf":{"@type":"Periodical","name":"J Am Heart Assoc"},"author":[{"@type":"Person","name":"Pu J"},{"@type":"Person","name":"Hastings KG"},{"@type":"Person","name":"Boothroyd D"},{"@type":"Person","name":"Jose PO"},{"@type":"Person","name":"Chung S"},{"@type":"Person","name":"Shah JB"},{"@type":"Person","name":"Cullen MR"},{"@type":"Person","name":"Palaniappan LP"},{"@type":"Person","name":"Rehkopf DH"}],"sourceOrganization":{"@type":"MedicalOrganization","name":"Palo Alto Medical Foundation Research Institute"},"about":[{"@type":"DefinedTerm","name":"Cardiovascular Diseases","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Cardiovascular+Diseases%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Cerebrovascular Disorders","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Cerebrovascular+Disorders%22%5D%7D%5D&verticalKey=research_publication"},{"@type":"DefinedTerm","name":"Health Disparities","url":"https://www.sutterhealth.org/research-search-results?facets=%5B%7B%22i%22%3A%22c_researchTopics.name%22%2C%22v%22%3A%5B%22Health+Disparities%22%5D%7D%5D&verticalKey=research_publication"}],"mainEntityOfPage":{"@type":"WebPage","@id":"https://www.sutterhealth.org/research/publications/geographic-variation-cvd-mortality-asian-ams-1055312318","breadcrumb":{"@id":"https://www.sutterhealth.org/research/publications/geographic-variation-cvd-mortality-asian-ams-1055312318#breadcrumblist"}}} ```