Abstract Body: Introduction: While stroke-related health disparities among certain racial/ethnic groups in the US are well-documented, less is known about outcomes for Asian Americans. Despite lower overall mortality rates, Asians globally may face a high stroke burden, particularly in East and Southeast Asia. This study investigates whether Asian Americans exhibit elevated risks for stroke-related mortality compared to other racial/ethnic groups in the US.
Methods: We analyzed 2011-2014 National Health and Nutrition Examination Survey (NHANES) data linked to mortality records through December 2019. Outcomes included all-cause and stroke-specific mortality (ICD-10 codes I60-I69). Race/ethnicity was self-reported as Non-Hispanic White, Black, Asian, Hispanic, and Other. Cox proportional hazard models examined mortality risks by race/ethnicity, adjusting for age and sex.
Results: Among 9,860 participants, the demographic breakdown revealed a consistent distribution of sex and age across racial/ethnic groups, with females comprising about half of each group. The mean age ranged from 21.0 years (Other) to 37.5 years (Non-Hispanic White), and non-Hispanic Asians were at about 32 years. For all-cause mortality, non-Hispanic Asians (HR=0.40, 95% CI: 0.30-0.53) and Hispanics (HR=0.62, 95% CI: 0.51-0.75) showed significantly lower hazard ratios compared to non-Hispanic Whites. However, for stroke-related mortality, non-Hispanic Asians showed a higher risk (HR=2.60, 95% CI: 1.15-5.92) relative to the reference group.
Conclusions: Our findings reveal a potential paradox that while Asian Americans have lower all-cause mortality, they may face higher stroke-related mortality risks compared to non-Hispanic Whites. This aligns with global patterns of high stroke burden in Asian populations. These results highlight the need for further investigation around vascular risk factor profiles in Asian populations and the need for targeted stroke prevention and management strategies for Asian Americans, despite their overall health advantages in other areas.