Elsevier

The American Journal of Cardiology

Volume 189, 15 February 2023, Pages 11-21
The American Journal of Cardiology

Social Determinants of Health, Cardiovascular Risk Factors, and Atherosclerotic Cardiovascular Disease in Individuals of Vietnamese Origin

https://doi.org/10.1016/j.amjcard.2022.11.028Get rights and content

In 2022, the Vietnamese population in the United States (US) comprises 2.2 million individuals, and Vietnam ranks as the sixth most frequent country of origin among immigrants in the US. The American Heart Association and the National Institutes of Health have called for research to define the burden of cardiovascular risk factors, cardiovascular disease, and their determinants across Asian American subgroups, including Vietnamese Americans. Despite these calls, Vietnamese Americans remain remarkably overlooked in cardiovascular research in the US. Studies in Vietnam, small cross-sectional surveys in the US, and research using US mortality data point to a high prevalence of hypertension and tobacco use among men and a high incidence of gestational diabetes among women. Moreover, Vietnamese Americans have one of the highest rates of cerebrovascular mortality in the country. Adverse social determinants of health—including frequent language barriers, limited health literacy, and low average income—have been suggested as important factors that contribute to cardiovascular risk in this group. In this narrative review, we summarize the existing knowledge in this space, highlight the distinct characteristics of cardiac risk in both Vietnamese and Vietnamese American individuals, discuss upstream determinants, and identify key knowledge gaps. We then outline several proposed interventions and emphasize the need for further studies in this underrepresented population. Our aim is to increase awareness of the significant burden of risk factors and cardiovascular disease shouldered by this large—but thus far overlooked—population in the US, boost research in this space, and help inform tailored, effective preventive interventions.

Section snippets

Discussion

Vietnam is a Southeast Asian country that shares its borders with Cambodia, Laos, the South China Sea, and the Indochinese peninsula5 (Figure 1). Since the 2nd century BC, Vietnam had been ruled by many different Chinese dynasties until it developed into its own independent state in 938 AD.6 From 938 to the mid-1500s, Vietnam experienced a period of renaissance and was ruled under the Ly, Tran, Ho, and Le So dynasties. It was not until the early 19th century that Western countries first entered

Conclusions

Vietnamese American men and women represent a sizable and growing proportion of the US population and have one of the highest cerebrovascular mortality rates in the country. Adverse SDOH, high rates of tobacco use among men, high rates of gestational diabetes among women, and hypertension seem to be important determinants of cardiovascular risk in this group. However, many of these findings have been informed by relatively small studies, and there is a need to better understand the contemporary

Disclosures

The authors have no conflicts of interest to declare.

References (72)

  • US News & World Report. Vietnam. Available at:https://www.usnews.com/news/best-countries/vietnam. Accessed on May 15,...
  • Consulate of the Socialist Republic of Vietnam in New York. Brief History of Vietnam. Available...
  • Asia for Educators. Vietnam—Timeline of Historical Periods. Available...
  • Britannica. Vietnam: government and society. Available...
  • US News & World Report. Best countries for education. Available...
  • Statista. Demographics in Vietnam – statistics and facts. Available...
  • Zhou M, Bankston III CL. The experience of Vietnamese refugee children in the United States. Available...
  • Pew Research Center. Vietnamese Americans. Available...
  • Immigration Policy Center. From refugees to Americans: thirty years of Vietnamese immigration to the United States....
  • Migration Policy Institute. Vietnamese immigrants in the United States; 2021, October 15. Available...
  • Ethnic Media Services. How the U.S. Census impacts the Vietnamese community. Available...
  • D Sorkin et al.

    Self-reported health status of Vietnamese and non-Hispanic white older adults in California

    J Am Geriatr Soc

    (2008)
  • Pew Research Center. English proficiency of Vietnamese population in the U.S., 2015. Available...
  • Statista. Vietnam: life expectancy at birth from 2010 to 2020, by gender. Available...
  • Macrotrends. Vietnam life expectancy 1950–2022. Available...
  • World Health Organization. Cardiovascular diseases (CVD) in Viet Nam. Available...
  • QN Nguyen et al.

    Cardiovascular disease risk factor patterns and their implications for intervention strategies in Vietnam

    Int J Hypertens

    (2012)
  • NTT Nhung et al.

    Estimation of Vietnam national burden of disease 2008

    Asia Pac J Public Health

    (2014)
  • CSP. Lam

    Heart failure in Southeast Asia: facts and numbers

    ESC Heart Fail

    (2015)
  • Global, regional, and national comparative risk assessment of 79 behavioural, environmental and occupational, and metabolic risks or clusters of risks, 1990–2015: a systematic analysis for the Global Burden of Disease Study 2015

    Lancet

    (2016)
  • H Van Minh et al.

    Prevalence of tobacco smoking in Vietnam: findings from the Global Adult Tobacco Survey 2015

    Int J Public Health

    (2017)
  • World Health Organization. Smoking causes 40 000 deaths in Viet Nam each year. Available...
  • PT Son et al.

    Prevalence, awareness, treatment and control of hypertension in Vietnam-results from a national survey

    J Hum Hypertens

    (2012)
  • HTP Do et al.

    National prevalence and associated risk factors of hypertension and prehypertension among Vietnamese adults

    Am J Hypertens

    (2015)
  • Global burden of 87 risk factors in 204 countries and territories, 1990–2019: a systematic analysis for the Global Burden of Disease Study 2019

    Lancet

    (2020)
  • TT Nguyen et al.

    Vietnam a country in transition: health challenges

    BMJ Nutr Prev Health

    (2020)
  • Cited by (0)

    Funding: None.

    View full text