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VIEWPOINT AND COMMENTARY: NEWS FROM THE NHLBI

Report of a National Heart, Lung, and Blood Institute Workshop: Heterogeneity in Cardiometabolic Risk in Asian Americans in the U.S.

Opportunities for Research

K.M. Venkat Narayan, MD^_*,_*, Larissa Aviles-Santa, MD, MPH, Reena Oza-Frank, PhD^_*, Mona Pandey, MPH, J. David Curb, MD, Marguerite McNeely, MD, Maria Rosario G. Araneta, PhD^||, Latha Palaniappan, MD^¶, Swapnil Rajpathak, MD, DrPH^#, Elizabeth Barrett-Connor, MD^|| for the Cardiovascular Disease in Asian and Pacific Islander Populations NHLBI Working Group

^_* Hubert Department of Global Health, Emory University, Atlanta, Georgia
National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland
Translational Research, Honolulu, Hawaii
University of Washington, Seattle, Washington
^|| University of California at San Diego, La Jolla, California
^¶ Palo Alto Medical Foundation Research Institute, Palo Alto, California
^# Albert Einstein College of Medicine, Yeshiva University, New York, New York

Manuscript received March 26, 2009; revised manuscript received July 22, 2009, accepted July 24, 2009.

^_* Reprint requests and correspondence: Dr. K. M. Venkat Narayan, Emory University, 1518 Clifton Road, Atlanta, Georgia 30322 (Email: knaraya{at}emory.edu).

The Asian and Pacific Islander population (Asian Americans) in the U.S. has increased dramatically in the last few decades. Yet, data on cardiovascular disease (CVD) in this population are scarce. The National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health conducted an Expert Workshop to: 1) assess the importance of studying CVD in Asian Americans in the U.S.; and 2) consider strategic options for further investigations of CVD in this population. There is considerable geographical, ethnic, cultural, and genetic diversity within this population. Limited data also suggest striking differences in the risk of CVD, obesity, type 2 diabetes mellitus, and other CVD risk factors across the Asian-American population. The Asian-American population is a new diverse pool with less contemporary genetic and cultural admixture relative to groups that have lived in the U.S. for generations, plus it is diverse in lifestyle including culture, diet, and family structure. This diversity provides a window of opportunity for research on genes and gene-environment interactions and also to investigate how acculturation/assimilation to U.S. lifestyles affects health and CVD risk among relatively homogenous groups of recent immigrants. Given the heterogeneity in body weight, body size, and CVD risk, the Asian-American population in the U.S. offers a unique model to study the interaction and relationships between visceral adiposity and adipose tissue distribution and beta cell function, insulin resistance, and atherosclerosis.

Key Words: cardiovascular disease • type 2 diabetes • Asian Americans • Pacific Islanders • ethnicity • disparity

Abbreviations and Acronyms   BMI = body mass index   CHD = coronary heart disease   CVD = cardiovascular disease   HDL = high-density lipoprotein   LDL = low-density lipoprotein   NHLBI = National Heart, Lung, and Blood Institute   NIH = National Institutes of Health   NHIS = National Health Interview Survey   NOHPI = Native Hawaiian or Other Pacific Islander

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