Abstract Body: Introduction-
The Global Burden of Disease Study suggested 80% of obesity & overweight (OOW) related deaths in US have an underlying cause of either type 2 diabetes, chronic kidney disease, dyslipidaemias & hypertensive heart disease (DKOLH). Studying OOW related cardiovascular deaths (CVD) in Asian Americans (AA), a population known to have heterogeneous risk CVD by nation of origin has not been well studied.

Methods-
National Vital Statistics System (NVSS) mortality data extracted (2005-2019) for 6 AA subgroups and non-Hispanic Whites between 35-74 years of age (premature). Identified OOW-related CVD with one or more of DKOLH by using ICD.10 coding. Population estimates from American Community Survey (ACS). Age and sex specific mortality rates calculated using negative binomial regression. Weighted average rates calculated for premature deaths in RStudio and Average Annual Percentage Change (AAPC) calculated using Joinpoint Regression Program.

Results-
For OOW related premature mortality - significant increase in AAPC across all subgroups of AA males (p<0.05), AAPC for Japanese (-3.4%, 95%CI -5.1 to -1.7) females significantly decreased, AAPC for Chinese and Asian Indian females has not shown any significant change over the years, highest AAPC for Koreans and Vietnamese over years for both males (7.01%, CI 4.6-9.5%; 6.88% CI 5.4-8.4%) and females (3.62% CI 1.3-5.9% ; 3.82% CI 1.7-6%). Trends for mortality rates across years remain highest for Filipinos for both genders. The rise in premature OOW related CVD for all AA males is disproportionately higher than the change in their respective all-cause premature mortality over years, for females it is disproportionately higher only for Filipinos (p<0.05).

Conclusions-
Our study demonstrates a novel way to use NVSS mortality data for estimating premature OOW related CVD rate using reliable population estimates. Decline in Japanese and Chinese female OOW related premature CVD needs to be appreciated and factors leading to the same need to explored, while disproportionate rise in amongst all AA males particularly Koreans and Vietnamese when compared to their respective all-cause mortality is alarming and warrants further direct targeted interventions, while persistently high and rising mortality rates amongst Filipinos demonstrate ineffectiveness of current strategies at various levels of prevention.