Abstract Body (Do not enter title and authors here): Aims
Asian Americans experience disproportionate burdens of cardiovascular risk factors and cardiovascular disease (CVD). However, the trends in cardiovascular risks in adults from different Asian ethnic backgrounds remain understudied. Therefore, we examined the temporal trends in cardiovascular conditions among Chinese, Filipino, and Asian Indian adults living in the U.S.

Methods
We conducted a cross-sectional analysis using the 2004-2018 National Health Interview Survey. Age-standardized prevalence rates were calculated for eight conditions, including hypertension, type 2 diabetes, alcohol use, smoking, physical inactivity, overweight/obesity, short sleep (< 7 hours), and CVD (defined as having coronary heart disease, heart attack, or stroke). Average annual percent change (AAPC) was employed to summarize and compare the trend of each outcome of interest over 15 years.

Results
The sample consisted of 14,073 Asian adults, with 13% aged 65 years or older and 53% female. Of the sample, Filipino adults had the highest prevalence rates for most conditions, except for physical inactivity and overweight/obesity. Over 15 years, Chinese adults showed a 2% annual increase in short sleep (p = 0.010). Asian Indian adults exhibited uptrends in overweight/obesity (AAPC: 1.1%, p < 0.001) and alcohol use (AAPC: 2.3%, p < 0.001), but downtrends in smoking (AAPC: -4.8%, p = 0.005) and physical inactivity (AAPC: -0.8%, p < 0.001). Filipino adults demonstrated similar trends in the prevalence of alcohol use and smoking, with AAPCs at 1.6% (p = 0.001) and -3.1% (p = 0.001), respectively. No significant trends were found for other cardiovascular conditions in all three groups.

Discussion
Our study assessed temporal trends in CVD and its risk factors among the three largest Asian ethnic groups in the U.S. The findings showed that Asian Americans from different ethnic backgrounds face varying disparities in cardiovascular health. Public health strategies should be customized to effectively address specific cardiovascular risks for each Asian subgroup.