heart and medicine

A study examining heart failure and Asian-American patients is one of the few looking at heart health within the minority group.

The study – which examined the clinical profile, quality of care and health outcomes for 153,023 patients with heart failure at 356 medical centers – showed Asian-American heart failure patients are more likely than their white counterparts to  have chronic conditions such as diabetes, hypertension and renal disease.

It also showed Asian-American patients were younger, more likely to be male, and to be uninsured or covered by Medicaid. The study included 149,249 white patients and 3,774 Asian-American patients.

Little has been known about Asian-American patients with heart failure, said the report’s lead author, Dr. Feng “Johnson” Qian, assistant professor of Health Policy and Management at the University at Albany School of Public Health. Yet, fueled primarily by immigration, Asian-Americans have become the fastest growing racial group in the United States, with a growth rate of 2.9 percent, compared with Hispanics at 2.1 percent.

“Asian-American health is one I have a passion for,” said Qian, who trained as a surgeon in Shanghai, China, and completed a fellowship and master’s degree at the National University of Singapore. He then earned his PhD in health services research and policy from the University of Rochester. “I also think it is understudied and very heterogeneous. … We need to dig deeper and find out more about each sub group, to help in diagnosis, disease education, health promotion and treatment.”

His latest research was the third major paper Qian has published on Asian-Americans and heart health since 2012. Qian said all three received funding from the American Heart Association. The latest study was published online in April and was printed on June 15 in the International Journal of Cardiology. It is called Characteristics, Quality of Care, and In-Hospital Outcomes of Asian-American Heart Failure Patients: Findings from the American Heart Association Get With The Guidelines-Heart Failure Program. 

Overall, it shows that Asian-American heart failure patients had comparable quality of care in Get With The Guidelines-participating hospitals except that they were less likely to receive diuretics called aldosterone antagonists at discharge from the hospital and anticoagulation for atrial fibrillation.

Get With The Guidelines is the AHA’s quality improvement program that reaches patients nationwide. Compared with white patients, Asian-American patients also had similar likelihood of hospital stays greater than four days and risk rates for dying while in the hospital. The study showed Asian-Americans were more likely to be discharged home.

Each Asian community has different cultural attitudes and traditions toward health and medicine, determining whether and how they reach out for help, their views on medicine and more, Qian said. So, deeper study is needed so that there can be better culturally-tailored strategies for health education and preventative care.

Another study late last year also pointed out the need to further research into racial and ethnic differences in cardiovascular disease among Asian-Americans.

In December, a group from Palo Alto Medical Foundation Research Institute and Stanford University in California reported its findings from a review of 10.4 million death records to determine that Asian Indian men and women and Filipino men had a greater risk of dying from ischemic heart disease.

The records from 2003 to 2010 came from states that had heart disease and stroke death information for the six largest Asian-American subgroups – Chinese, Japanese, Filipino, Asian Indian, Korean and Vietnamese Americans – which account for 84 percent of Asians in the United States, according to the U.S. Census. That study also concluded the risk of death from hypertensive heart disease and hemorrhagic stroke was higher in every Asian-American subgroup than in non-Hispanic whites.

“Because we know so little so far,” Qian said. “We need to be better prepared in how we should take care of this minority group.”