Prevalence of Diabetes and Cardiovascular Disease in Indians in the U.S.

Two articles from 2004 show an increased prevalence of diabetes within the Asian Indian population compared to Whites, Blacks, and Hispanics in two separate cohorts in the U.S. The investigators who wrote the article which also studied CVD found no apparent increase in prevalence or risk. There are limited studies regarding chronic conditions in South Asians in the United States; the majority of studies pertaining to chronic conditions in South Asians to date have been done in the United Kingdom or Canada.

The abstracts and citations of the two studies are provided below.

1. Prevalence of Diabetes Mellitus and Related Conditions in Asian Indians Living in the United States

Rajesh Venkataraman, MD, MPH, Navin C. Nanda, MD, Gurpreet Baweja, MD, Naresh Parikh, MD, and Vishal Bhatia, MD

This study is the first attempt to evaluate the prevalence of diabetes mellitus and related conditions in Asian Indians living in the United States. A community- based survey of 1,046 Asian Indian immigrants living in and around the Atlanta metro area of Georgia was conducted and found an overall prevalence of diabetes mellitus of 18.3% (22.5% in men and 13.6% in women). This prevalence of diabetes mellitus in Asian Indians is much higher than in whites, blacks, and Hispanics living in the United States.

2004 by Excerpta Medica, Inc. (Am J Cardiol 2004;94:977–980)
• • •
From the Division of Cardiovascular Disease, The University of Alabama at Birmingham, Birmingham, Alabama. Dr. Nanda’s address is: The University of Alabama at Birmingham, Heart Station/ Echocardiography Laboratories, 619 South 19th Street, SW-S102, Birmingham, Alabama 35249. E-mail: nanda@uab.edu. Manuscript received April 2, 2004; revised manuscript received and accepted June 16, 2004.

2. Diabetes and Cardiovascular Disease Among Asian Indians in the United States
Sarita A. Mohanty, MD, MPH,1 Steffie Woolhandler, MD, MPH,2 David U. Himmelstein,2 MD,
David H. Bor, MD2

1Department of Medicine, Division of Geriatric and General Internal Medicine, University of Southern California, Los Angeles, CA, USA;
2Department of Medicine, Cambridge Health Alliance/Harvard Medical School, Cambridge, MA, USA.

CONTEXT: Studies, mostly from outside the United States, have found high prevalence of diabetes, coronary heart disease (CHD), and hypertension among Asian Indians, despite low rates of associated risk factors.
OBJECTIVE: To analyze the prevalence of obesity, diabetes, CHD, hypertension, and other associated risk factors among Asian Indians in the United States compared to non-Hispanic whites.
DESIGN, SETTING, AND SUBJECTS: Cross-sectional study using data from the National Health Interview Survey (NHIS) for 1997, 1998, 1999, and 2000. We analyzed 87,846 non-Hispanic whites and 555 Asian Indians.
MAIN OUTCOME MEASURES: Whether a subject reported having diabetes, CHD, or hypertension.
RESULTS: Asian Indians had lower average body mass indices (BMIs) than non-Hispanic whites and lower rates of tobacco use, but were less physically active. In multivariate analysis controlling for age and BMI, Asian Indians had significantly higher odds of borderline or overt diabetes (adjusted OR [AOR], 2.70; 95% confidence interval [CI], 1.72 to 4.23). Multivariate analysis also showed that Asian Indians had nonsignificantly lower odds ratios for CHD (AOR, 0.58; 95% CI, 0.25 to 1.35) and significantly lower odds of reporting hypertension (AOR, 0.58; 95% CI, 0.42 to 0.82) compared to non-Hispanic whites.
CONCLUSION: Asian Indians in the United States have higher odds of being diabetic despite lower rates of obesity. Unlike studies on Asian Indians in India and the United Kingdom, we found no evidence of an elevated risk of CHD or hypertension. We need more reliable national data on Asian Indians to understand their particular health behaviors and cardiovascular risks. Research and preventive efforts should focus on reducing diabetes among Asian Indians.
KEY WORDS: Asian Indian; diabetes; coronary heart disease; hypertension; obesity.
DOI: 10.1111/j.1525-1497.2005.40294.x
J GEN INTERN MED 2005; 20:474–478.