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Over the past few decades, heart researchers have followed hundreds of older Chinese American immigrants living in Los Angeles and Chicago as part of a study examining the link between immigration and cardiovascular disease.
As the years passed, some of the participants, who were on average 62 years old at the start of the study, became ill from heart disease and some died. And a trend has emerged.
The longer immigrants lived in the United States, the higher their cardiovascular risk. And where in the United States they lived also appears to be a factor.
Immigrants who settled in Los Angeles had higher death rates from heart disease than immigrants in Chicago.
“This is a big surprise,” said the study’s lead author, Dr. Xinjiang Cai, a cardiologist at UCLA.
Cai speculated that Angelenos would become more physically active, an important aspect of heart health. Because “Los Angeles has better weather than Chicago.”
However, immigrants in LA reported less physical activity than Chicagoans.
In addition to being more physically active, people in the Windy City are also more highly educated, which translates into better socio-economic and health outcomes.
receive early intervention
More research is needed to explain the geographic disparities found in a study published this month in the journal American Heart Association, Cai said.
However, his discoveries about physical activity led him to further strengthen his beliefs. That means exercising for at least 30 minutes five times a week. What if you can’t quite get there?
“Any exercise during the week is better than no exercise,” Kai says.
Kai said other important interventions can reduce the risk of heart disease.
Eat a healthier diet Stop smoking Reduce your stress levels Get enough sleep Manage your weight Manage your cholesterol levels, especially the bad LDL Manage your blood sugar levels Keep your blood pressure within normal range Heart problems, such as chest pain and slow heart rate Pay attention to potential symptoms of the disease: shortness of breath, difficulty breathing, dizziness, palpitations
cultural hurdles
Tsai said clinicians must overcome language and cultural barriers to ensure immigrants receive appropriate cardiac care.
Tsai describes the relief she felt when her Chinese immigrant patients saw her.
“They say, ‘Oh, teacher, you speak Chinese, so I’m very happy to meet you,'” Tsai said.
Cai also recognizes that some patients may rely on a combination of Western and Eastern medicine, such as taking herbal medicine. And he knows that the Chinese diet is high in carbohydrates, as rice and noodles are staple foods. He advises people at risk for heart disease to change their taste buds.
“Typically, we recommend a Mediterranean diet to our patients because it tends to be healthier,” Cai says.
what’s next
Of the original 746 participants, 560 are still alive and active in the ongoing study, taking exams and participating in interviews.
Tsai said that because Asian Americans are such a diverse group, there are limits to how findings from Chinese immigrants can be extrapolated to other ethnic groups. He noted that among Asian Americans, South Asians tend to be at higher risk for cardiovascular disease.
“So genetic background definitely plays a very important role here,” Cai said. “You still have to pay attention to environmental factors.”
Historically, Asian Americans have been underrepresented in clinical research and trials. That’s starting to change this year with the launch of the first long-term cancer study in Asian Americans. In Southern California, cancer centers at Cedars-Sinai and the University of California, Irvine are currently recruiting participants.
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