Introduction: Asian Indian (AI) men and women in the United States have a greater proportionate mortality burden from ischemic heart disease compared to non-Hispanic whites. We sought to further characterize patterns of cardiovascular disease (CVD) mortality in AIs in the United States.
Methods: We identified 33,526 AI decedents from CVD, aged 40+ years, in the U.S. mortality records from the National Center for Health Statistics between 2003-2012. AIs were categorized as U.S. born (N = 662) versus foreign born (N = 32,864), and were compared to non-Hispanic White (NHW) decedents (N = 17,726,420). Characteristics of the decedents, such as age at death, were compared between groups with analysis of variance.
Results: Foreign born AI decedents were more likely to be men compared to NHWs (58.3% vs. 48.4%, p<0.0001), although there was no significant difference in proportion of male decedents between foreign born and U.S. born AIs (p=0.06). Foreign born AIs had a significantly lower median age at death from CVD (72 years, 25th-75th percentile range 61-81 years) compared to NHWs (79 years; range 68-87 years; p<0.0001), but there was no significant difference between age at death from CVD compared to U.S. born AIs (70.5 years, range 57-82 years; p=0.1). Compared to foreign born AIs, U.S. born AIs had a higher frequency of deaths from CVD at younger ages (40-59 years, 29.1% of CVD deaths vs. 21.9% of CVD deaths in foreign born AIs) and in the highest age category (85+ years, 19.5% of CVD deaths vs. 16.6% of CVD deaths in foreign born AIs; p for age group comparisons <0.0001).
Conclusions: These results demonstrate substantial differences in mortality patterns between foreign born AIs and NHWs in the U.S., as well as evidence supporting differences in AI mortality patterns based on nativity. These findings may reflect differences in CVD risk profiles in these populations. We hypothesize that these results may also suggest potential influences of environment and lifestyle on CVD mortality in AIs. However, further research is needed to better characterize CVD mortality patterns in AIs, especially in U.S. born AIs.