Evidence mapPaperPMID 40240959Full record

ArticleJournal of the American Heart Association2025

Differences in Coronary Heart Disease and Stroke Incidence Among Single-Race and Multiracial Asian and Pacific Islander Subgroups in Hawaii and California: A Retrospective Cohort Study.

Yihe G Daida, Ana Gabriela Rosales, Timothy B Frankland, Adrian Matias Bacong, Beth Waitzfelder, Jiang Li, Joseph Keawe'aimoku Kaholokula, Latha Palaniappan, Stephen P Fortmann

Abstract readComparative Study
In one paragraph

Article in Journal of the American Heart Association, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

9 authors.

Yihe G DaidaCenter for Integrated Health Care Research Kaiser Permanente Honolulu HI USA.ORCID 0000-0003-1628-0476
Ana Gabriela RosalesKaiser Permanente Center for Health Research Portland OR USA.
Timothy B FranklandCenter for Integrated Health Care Research Kaiser Permanente Honolulu HI USA.ORCID 0000-0002-0987-8405
Adrian Matias BacongStanford University School of Medicine Stanford CA USA.ORCID 0000-0003-0157-4754
Beth WaitzfelderCenter for Integrated Health Care Research Kaiser Permanente Honolulu HI USA.ORCID 0000-0003-2134-1958
Jiang LiPalo Alto Medical Foundation Research Institute, Sutter Health Palo Alto CA USA.ORCID 0000-0003-4183-1006
Joseph Keawe'aimoku KaholokulaDepartment of Native Hawaiian Health John A. Burns School of Medicine, University of Hawaii Honolulu HI USA.ORCID 0000-0001-5076-6141
Latha PalaniappanStanford University School of Medicine Stanford CA USA.ORCID 0000-0002-1245-665X
Stephen P FortmannKaiser Permanente Center for Health Research Portland OR USA.ORCID 0000-0002-1327-9341

Funding

META - Mentor, Educate, Train, Advocate: Patient Oriented Researchers in Cardiometabolic DiseaseK24HL150476 · NHLBI · STANFORD UNIVERSITY · 2022 to 2025
$479k
NCATS NIH HHS UL1 TR003142NHLBI NIH HHS K24 HL150476NHLBI NIH HHS R01 HL126172
6 · The paper itself

Abstract

backgroundLittle is known about clinical and sociodemographic factors affecting coronary heart disease (CHD) and stroke incidence in single-race and multiracial American Asian, Native Hawaiian, and Pacific Islander subgroups. As the US population becomes more diverse, it is important to characterize differences in risks for CHD and stroke, and their contributing factors, in these populations. METHODS AND

resultsThe study population included 303 958 patients from Kaiser Permanente Hawaii and Palo Alto Medical Foundation in California. Self-reported race and ethnicity were derived from electronic health records and 12 mutually exclusive single-race and multiracial groups were created for analyses. Cox proportional hazard models were used to compare CHD and stroke incidence. Unadjusted models were compared with models adjusted for age, income, education, body mass index, smoking, and comorbidities. We found up to a 4-fold variation in CHD and stroke rates among American Asian, Native Hawaiian, and Pacific Islander subgroups. Multiracial subgroups had higher rates than single-race groups. While most single-race American Asian, Native Hawaiian, and Pacific Islander groups had lower CHD and stroke risks, middle-aged Asian Indian men and Native Hawaiian women had higher stroke risks than non-Hispanic White controls. Income, education, body mass index, smoking, and comorbidities contributed significantly to risks in all groups, especially in Native Hawaiian, Pacific Islander, and multiracial groups.

conclusionsRisks for CHD and stroke vary by racial and ethnic subgroups, demonstrating the need to unmask risks by disaggregating racial and ethnic subgroups. Multiracial American Asian, Native Hawaiian, and Pacific Islander groups had higher risks that were only partially explained by modifiable risk factors. Future studies should further explore lifestyle, psychosocial, and sociocultural factors.

Indexed as

Coronary DiseaseStrokeAgedAsian American Native Hawaiian and Pacific IslanderCaliforniaFemaleHawaiiHumansIncidenceMaleMiddle AgedNative Hawaiian or Pacific IslanderRetrospective StudiesRisk FactorsAsiancardiovascular diseasemultiracialPacific Islanderstroke

Identifiers

PMID40240959
PMCPMC12184270

What Socratic holds

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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.