Adult Health Issues: Epidemiology of Cardiovascular Diseases

Note

Because of the limited amount of research that has been conducted with Hmong American elders, we expanded our literature review to include research that has been conducted with adults who are 21 years and older.

There have been no longitudinal epidemiological studies about incidence rates of cardio-vascular disease (CVD) in the Hmong who arrived in 1970s-1990s. Nonetheless, some studies have shown rising rates of CVD.

CVD Mortality Rate Increase

An examination of change in diagnoses on death certificates in Fresno, CA indicated that the mortality rates for CVD increased from 16% in 1980-1989 to 22% in 1990-1994 to 29% in 1995-1999 (Kunstadter & Vang, 2001). (See Figure 2 below.)

Figure 2:CVD Mortality Rates

 

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Community-Based Studies

Various community-based studies on volunteer samples in the 1990s revealed the incidence of:

  • hypertension (HTN)=16%-33%
  • DM=16-42%
  • overweight=81%
  • obesity=31%,
  • stroke=4%,
  • heart attack <0.01%

(Her & Mundt, 2005: Kunstadter, 2001; Kwan & Moua 2002; Lee, Xiong, Vang, & Comerford, 2000)

One study (Lee, Xiong, Vang, & Comerford, 2000) found a direct relationship between length of time in U.S. and presence of HTN as well as obesity. Another study found high rates of CVD co-morbidities in people with type 2 diabetes (62% hyperlipidemia, 54% proteinuria, and 23% HTN) (Culhane-Pera, et al., 2005).

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Study of Newly-Arrived Hmong Adults

A cross-section epidemiological study of newly arriving Hmong adults from Wat Tham Krabok Thailand to MN in 2004-2005 revealed prevalence rates of:

  • HTN=16%
  • pre-HTN= 36%
  • DM=3%
  • hyperglycemia=32%
  • overweight=33%
  • obesity=15%
    (Culhane-Pera, Moua, DeFor, & Desai, 2008)

Comparing with non-refugee Hmong in Thailand in the mid-1990s, rates of HTN, DM, and obesity were <0.01% (Kunstadter 2001).) It is speculated that sedentary lifestyles at the Buddhist temple refugee camp contributed to high rates of obesity and HTN. It is doubtful that people who arrived during the 1970s-1990s had similarly high rates of obesity
and HTN.

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Rates of Renal Disease and Renal Failure

Overall, providers have noted high rates of renal disease and renal failure within the Hmong-American population. However, there is no statistics available regarding prevalence. It is noted that at one dialysis unit in St. Paul MN, approximately 25% of the patients are Hmong (Ann Rinehart, personal communication 2003).

At another dialysis unit in Minneapolis MN, the average age of Hmong patients is estimated to be 10 years lower than the general population (Arkady Synhavsky, personal communication 2003).
These reports could indicate that Hmong Americans have a higher prevalence of renal disease than the general population. This may be due to a high rate of a genetic renal disease, gout, and other unknown factors.

Urologists have noted high rates of gout, uric acid stones, and complications, such as staghorn calculi and loss of kidneys in Hmong Americans (Portis, Hermans, Culhane-Pera, & Curhan, 2004) A community study of adults > 18 years of age in St. Paul revealed 4.5% had renal stones (Moua 2004). On arrival in 2004-2005, 12% of adults > 21 years of age tested had high uric acid levels (Culhane-Pera, Moua, DeFor, & Desai, 2008)

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