Atherosclerotic Cardiovascular Disease Risk Prediction Models in China, Japan, and Korea: Implications for East Asians? - PubMed (original) (raw)
Review
Atherosclerotic Cardiovascular Disease Risk Prediction Models in China, Japan, and Korea: Implications for East Asians?
Patricia K Nguyen et al. JACC Asia. 2025 Mar.
Abstract
The management of atherosclerotic cardiovascular disease (ASCVD) in the United States is currently based upon large epidemiological studies in primarily non-Hispanic White subjects. Although this strategy provides a uniform approach that is simpler to implement, it may result in inappropriately targeting certain Asian populations for treatment based on inaccurate ASCVD risk estimation. In this state-of-the-art review, we detail the similarities and differences in the prevalence of ASCVD and its risk factors among Chinese, Japanese, and Korean people living in the United States and in their native countries. We highlight the limitations of current risk calculators when applied to East Asian immigrants and summarize risk stratification approaches in China, Japan, and Korea. Our review underscores the need to disaggregate registry, cohort, and clinical trial data by East Asian subgroups, to actively engage these populations in research, and to initiate studies to better define ASCVD risk in East Asian people living in the United States.
Keywords: Asian immigrants; China; East Asia; Japan; Korea; atherosclerosis; coronary artery disease; stroke.
Copyright © 2025 The Authors. Published by Elsevier Inc. All rights reserved.
Conflict of interest statement
Funding Support and Author Disclosures Dr Nguyen has received support from the American Heart Association (AHA 23SCISA1145819). Dr Okamura has received funding support from Grant-in-Aid for Scientific Research (A) (21H04854) and Health and Labour Sciences Research Grants, Japan (Comprehensive research on lifestyle related diseases including cardiovascular diseases and diabetes mellitus) (24FA1002). Dr Wong has received funding through his institution from Amgen, Novartis, Novo Nordisk and Regeneron; and is a consultant for Amgen, Heart Lung, Ionis, and Novartis. Dr Yang is supported by the UW Medicine Asian Health Initiative and the Carl and Renée Behnke Endowed Chair for Asian Health; has received research funding from Microsoft Research; is a stockholder and advisory board member for Measure Labs; and is a consultant for Idorsia, Genentech, and Mineralys. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
Figures
Graphical abstract
Figure 1
Age-Standardized and Crude Mortality Rates for Major CVD (2019) (A) Age-standardized cardiovascular disease (CVD) mortality rate (per 100,000 population). (B) Crude CVD mortality rate (per 100,000 population). Data was obtained from the open database of the Global Burden of Disease Study in the Global Health Data Exchange. IHD = ischemic heart disease.
Figure 2
Proportion of Subtypes of CVD in Total CVD Death Percentage of total cardiovascular disease (CVD) deaths attributable to ischemic heart disease, stroke, and other CVDs in China, Japan, and South Korea, and all of East Asia. The proportion of deaths caused by stroke are further stratified into the percentage of total stroke deaths caused by ischemic or hemorrhagic stroke. Data were obtained from the open database of the Global Burden of Disease Study in the Global Health Data Exchange.
Central Illustration
East Asian Cardiovascular Risk Calculators Comparing cardiovascular risk calculators: China, Japan, Korea, United States, and Europe. Filled circles: included in all risk calculators; half-filled circles: included in some risk calculators; open circles: not included in risk calculators; circles with bold outlines: risk enhancer (American College of Cardiology [ACC]/American Heart Association [AHA]) or risk modifier (European Society of Cardiology [ESC]). ∗Korea denotes the Republic of South Korea. CAD = coronary artery disease.
References
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