Abstract Body: Background: Despite being one of the fastest-growing minority groups in the US, Asian Americans are often studied as a single entity. While some research has explored subgroup differences in CVD risk, sex-specific disparities remain unclear. Since lifestyle, shaped by ethnic background, influences CVD risk, identifying sex-specific differences across subgroups is crucial for tailored interventions.

Hypothesis: We assessed the hypothesis that CVD risk factors vary significantly by sex among Asian American subgroups compared to White males.

Methods: We analyzed data from the National Health Interview Survey (NHIS) years 2010 to 2018 of 135,809 adults, categorized as non-Hispanic White and Asian subgroups (Chinese, Asian Indian, Filipino, Other Asian). Six CVD risk factors were assessed: hypertension, diabetes, high cholesterol, smoking, overweight, and physical inactivity. Poisson regression models estimated prevalence ratios (PRs), adjusted for demographic and healthcare characteristics. We assessed sex-specific disparities within subgroups, using non-Hispanic White males as the reference group. NHIS survey weights were employed to derive national estimates.

Results: The mean age was 51 ± 0.12 years overall, with Asian Indians being the youngest (40.30 ± 0.54 years). Hypertension prevalence was highest in Filipino males (PR 1.10, 95% CI 1.01–1.20), while Chinese females had the lowest prevalence (PR 0.58, 95% CI 0.51–0.66). Diabetes prevalence was reported highest in Asian Indian males (PR 1.42, 95% CI 1.16–1.74) compared to the reference group; however, across subgroups, other Chinese females reported the lowest prevalence of diabetes (PR 0.46, 95% CI 0.34–0.63). Filipino males had the highest prevalence of high cholesterol (PR 1.23, 95% CI 1.11–1.37). Smoking prevalence was highest among other Asian males (PR 0.84, 95% CI 0.74–0.94). Intriguingly, the prevalence of physical inactivity was significantly high across all female subgroups, with Asian Indian women (PR 1.27, 95% CI 1.18–1.36), followed by other Asian women (PR 1.22, 95% CI 1.15–1.28), Filipino women (PR 1.17, 95% CI 1.10–1.25), and Chinese women (PR 1.17, 95% CI 1.09–1.26) (see figure)

Conclusion: In conclusion, this study unveils significant sex-specific disparities in CVD risk factors among Asian American subgroups. Culturally tailored, targeted interventions are needed. Addressing these disparities can help mitigate CVD burden in high-risk, sex-specific population and improve health equity.