Educational Attainment and Prevalence of Cardiovascular Health (Life’s Simple 7) in Asian Americans

Asian Americans have a high burden of cardiovascular disease, yet little is known about the social patterning of cardiovascular health (CVH) in this population. We examined if education (<high school diploma, high school diploma, some college, and college degree+) was associated with CVH and if this varied by time in the United States (U.S.). Our study population included Asian Americans 20+ years of age sampled in the 2011-16 National Health and Nutrition Examination Survey (n = 1634). Ideal cardiovascular health was based on a composite score of adiposity, total cholesterol, blood pressure, blood glucose, smoking, physical activity, and diet. We fit sequential weighted multivariate logistic regression models for all analyses. The prevalence of ideal cardiovascular (CV) health was 17.1% among those living in the U.S. <10 years, 7.1% for those living in the U.S. >10+ years, and 15.9% for the U.S.-born. All models showed that low education compared to high education was associated with lower odds of having ideal CVH. This pattern remained in adjusted models but became non-significant when controlling for nativity (odds ratio = 0.34, 95% confidence interval: 0.10, 1.13). Models stratified by time in the U.S. were less consistent but showed similar education gradients in CVH. Low education is a risk factor for attaining ideal cardiovascular health among Asian Americans, regardless of time in the U.S.