CirculationAHA SCIENTIFIC STATEMENTEpidemiology of Diabetes and AtheroscleroticCardiovascular Disease Among Asian AmericanAdults:Implications,Management,and FutureDirections:A Scientific Statement From theAmerican Heart AssociationTak W.Kwan,MD,FAHA Chair;Sally S.Wong,PhD,RD,CDN FAHA;Yuling Hong,MD,PhD,FAHA;Alka M.Kanaya,MD,FAHA;Sadiya S.Khan,MD,Msc,FAHA;Laura L Hayman,PhD,RN FAHA;Svati H.Shah,MD,MHS FAHA;Francine K.Welty MD,FAHA;Prakash C.Deedwania,MD,FAHA;Asma Khalig,MD;Latha P.Palaniappan,MD,MS Vice Chair;on behalf of the American HeartAssociation Councl on Epidemiology and Prevention;Council on Lifestyle and Cardiometabolic Health;Council on Arteriosclerosis,Thrombosis and Vascular Biology;Council on Clinical Cardiology;Council on Cardiovascular and Stroke Nursing;and Council onGenomic and Precision MedicineABSTRACT:Asian American individuals make up the fastest growing racial and ethnic group in the United States.Despite thesubstantial variability that exists in type 2 diabetes and atherosclerotic cardiovascular disease risk among the different subgroupsof Asian Americans,the current literature,when available,often fails to examine these subgroups individually.The purpose ofthis scientific statement is to summarize the latest disaggregated data,when possible,on Asian American demographics.Downloadedprevalence,biological mechanisms,genetics,health behaviors,acculturation and lifestyle interventions,pharmacological therapy,complementary altemnative interventions,and their impact on type 2 diabetes and atherosclerotic cardiovascular disease.Onthe basis of available evidence to date,we noted that the prevalences of type 2 diabetes and stroke mortality are higher in allfromAsian American subgroups compared with non-Hispanic White adults.Data also showed that atherosclerotic cardiovasculardisease risk is highest among South Asian and Filipino adults but lowest among Chinese,Japanese,and Korean adults.Thishttp:/scientific statement discusses the biological pathway of type 2 diabetes and the possible role of genetics in type 2 diabetes andatherosclerotic cardiovascular disease among Asian American adults.Challenges to provide evidence-based recommendationsincluded the limited data on Asian American adults in risk prediction models,national surveillance surveys,and clinical trials,leading to significant research disparities in this population.The large disparity within this population is a call for action to thepublic health and clinical health care community,for whom opportunities for the inclusion of the Asian American subgroupsshould be a priority.Future studies of atherosclerotic cardiovascular disease risk in Asian American adults need to be adequatelypowered,to incorporate multiple Asian ancestries,and to include multigenerational cohorts.With advances in epidemiology anddata analysis and the availability of larger,representative cohorts,furthering refining the Pooled Cohort Equations,in addition toenhancers,would allow better risk estimation i
