NCHS Data Brief No. 140 ■ January 2014

U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES

Centers for Disease Control and Prevention

National Center for Health Statistics

Hypertension, Abnormal Cholesterol, and High 

Body Mass Index Among Non-Hispanic Asian Adults: 

United States, 2011–2012

Yutaka Aoki, Ph.D., M.S., M.H.S.; Sung Sug Yoon, Ph.D., R.N.; Yinong Chong, Ph.D.; and 

Margaret D. Carroll, M.S.P.H.

The number of Asian persons in the United States grew by more than 

40% between 2000 and 2010 (1). Asian persons now make up 4.9% of 

the population (2). To address the scarcity of health information based 

on physical measurements of Asian persons, non-Hispanic Asian persons 

were oversampled for the first time in the National Health and Nutrition 

Examination Survey (NHANES) 2011–2012. This report presents the 

prevalence of hypertension, abnormal cholesterol, and high body mass index 

(BMI) in non-Hispanic Asian adults aged 20 and over. Abnormal cholesterol 

and high BMI are defined based solely on measurements, while hypertension 

is defined based on blood pressure measurement and reported medication use.

Keywords: prevalence • education • foreign-born • National Health and 

Nutrition Examination Survey

During 2011–2012, most non-Hispanic Asian adults in the 

United States were foreign-born.

Key findings

Data from the National 

Health and Nutrition 

Examination Survey, 

2011–2012

• One-quarter (25.6%) of 

non-Hispanic Asian adults aged 

20 and over had hypertension 

in 2011–2012.

• Approximately 1 in 10 nonHispanic Asian adults had high 

total cholesterol.

• Just over 14% of nonHispanic Asian adults had 

low levels of high-density 

lipoprotein cholesterol.

• Just under 40% of nonHispanic Asian adults had a 

body mass index greater than 

25 kilograms per square meter.

†

 Significant difference in age proportions between non-Hispanic Asian and non-Hispanic white (p < 0.01). ‡

 Significant difference in foreign-born status between non-Hispanic Asian and non-Hispanic white (p < 0.001).

NOTES: Estimates were weighted by sample weights for participants who took part in standardized physical examinations 

conducted in mobile examination centers. Access data table for Figure 1 at: http://www.cdc.gov/nchs/data/databriefs/db140_table.

pdf#1.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

Figure 1. Selected demographic characteristics of non-Hispanic Asian and non-Hispanic white 

adults: United States, 2011–2012

Non-Hispanic Asian Non-Hispanic white

U.S.-born

Foreign-born‡

More than high school education

High school education or less

60 years and over

40–59 years

20–39 years†

Women

Men

15.5

84.5

72.1

27.9

19.3

37.1

43.6

53.8

46.2

95.8

4.2

69.5

30.5

30.0

38.6

31.4

51.7

48.3

0 20 40 60

Percent Percent

80 100 0 20 40 60 80 100
NCHS Data Brief ■ No. 140 ■ January 2014

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Similar to non-Hispanic white adults, slightly more than one-half (53.8%) of non-Hispanic Asian 

adults were women, and 72.1% had more than a high school education (Figure 1). Non-Hispanic 

Asian adults were slightly younger than non-Hispanic white adults, with 43.6% aged 20–39 and 

19.3% aged 60 and over compared with 31.4% and 30.0%, respectively. The majority (84.5%) of 

non-Hispanic Asian adults were foreign-born.

The prevalence of hypertension among non-Hispanic Asian adults 

increased with age and decreased with education.

About one-quarter (25.6%) of non-Hispanic Asian adults had hypertension [defined as having 

blood pressure greater than or equal to 140/90 millimeters (mm) mercury (Hg) or taking blood 

pressure-lowering medications] during 2011–2012 (Figure 2). Men and women did not differ in 

the prevalence of hypertension, but prevalence increased with age: 5.0% for the 20–39 age group, 

26.5% for the 40–59 age group, and 59.6% for the 60 and over age group. Hypertension was 

lower among those with more than a high school education (22.8%) than among those with a high 

school education or less (31.9%). The prevalence of hypertension did not differ significantly by 

foreign-born status.

0 10 20 30 40

Percent

50 60 70

U.S.-born

Foreign-born

More than high school education‡

High school education or less

60 years and over

40–59 years

20–39 years†

Women

Men

Total

† Significant increasing linear trend by age (p < 0.001). ‡ Significant difference by education level (p < 0.05).

NOTES: With the exception of age group-specific percentages, estimates were age adjusted by the direct method to the 2000 U.S. Census population using the 

age groups 20–39, 40–59, and 60 and over. Hypertension is defined as having systolic blood pressure greater than or equal to 140 mm Hg, having diastolic blood 

pressure greater than or equal to 90 mm Hg, or currently taking medication to lower high blood pressure. Access data table for Figure 2 at: 

http://www.cdc.gov/nchs/data/databriefs/db140_table.pdf#2.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

Figure 2. Prevalence of hypertension among non-Hispanic Asian adults, by sex, age, education, and foreign-born status: 

United States, 2011–2012 

25.6

26.8

24.5

5.0

26.5

59.6

31.9

22.8

26.1

21.2
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During 2011–2012, the prevalence of high total cholesterol among 

non-Hispanic Asian adults did not differ by sex, age, education, or 

foreign-born status.

The prevalence of high total cholesterol [measured as serum total cholesterol of at least 240 

milligrams per deciliter (mg/dL)] among non-Hispanic Asian adults was 10.3% (Figure 3). The 

prevalence of high total cholesterol did not differ significantly by sex, age, education, or 

foreign-born status.

0 5 10 15 20 25 30

U.S.-born

Foreign-born

More than high school education

High school education or less

60 years and over

40–59 years

20–39 years

Women

Men

Total

NOTES: With the exception of age group-specific percentages, estimates were age adjusted by the direct method to the 2000 U.S. Census population using the 

age groups 20–39, 40–59, and 60 and over. High total cholesterol is defined as having serum total cholesterol greater than or equal to 240 mg/dL. Access data 

table for Figure 3 at: http://www.cdc.gov/nchs/data/databriefs/db140_table.pdf#3.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

Percent

10.3

9.5

10.9

6.8

13.1

11.9

13.0

9.4

10.9

8.9

Figure 3. Prevalence of measured high total cholesterol among non-Hispanic Asian adults, by sex, age, education, and 

foreign-born status: United States, 2011–2012

The prevalence of low high-density lipoprotein (HDL) cholesterol was five 

times greater among non-Hispanic Asian men than women.

The prevalence of low HDL cholesterol (measured as serum HDL of less than 40 mg/dL) among 

non-Hispanic Asian adults was 14.3% (Figure 4). The prevalence of low HDL cholesterol 

was five times higher in men (24.5%) than in women (5.1%). Foreign-born adults had twice 

the prevalence of low HDL cholesterol compared with U.S.-born adults (15.4% and 7.7%, 

respectively). The prevalence of low HDL cholesterol did not differ significantly by age or 

education.
NCHS Data Brief ■ No. 140 ■ January 2014

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U.S.-born

Foreign-born‡

More than high school education

High school education or less

60 years and over

40–59 years

20–39 years

Women

Men†

Total 14.3

24.5

5.1

13.1

16.3

13.2

18.8

13.2

15.4

7.7

0 5 10 15 20 25 30

Percent

†

 Significant difference between men and women (p < 0.001). ‡

 Significant difference by foreign-born status (p < 0.05).

NOTES: With the exception of age group-specific percentages, estimates were age adjusted by the direct method to the 2000 U.S. Census population using the 

age groups 20–39, 40–59, and 60 and over. Low HDL cholesterol is defined as having serum HDL cholesterol less than 40 mg/dL. Access data table for Figure 4 

at: http://www.cdc.gov/nchs/data/databriefs/db140_table.pdf#4.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

Figure 4. Prevalence of measured low HDL cholesterol among non-Hispanic Asian adults, by sex, age, education, and 

foreign-born status: United States, 2011–2012

The prevalence of high BMI differed by sex and age among non-Hispanic 

Asian adults.

The prevalence of high BMI [a BMI of at least 25 kilograms per square meter (kg/m2)] among 

non-Hispanic Asian adults was 38.6% (Figure 5). Adult men had a higher prevalence of high BMI 

(43.0%) than did adult women (34.7%). The prevalence of high BMI increased with age, such 

that adults aged 40–59 and those aged 60 and over had a prevalence almost 1.5 times higher than 

those aged 20–39. The prevalence of high BMI did not differ significantly by education or by 

foreign-born status.
NCHS Data Brief ■ No. 140 ■ January 2014

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0 10 20 30 40 50 60

Percent

U.S.-born

Foreign-born

More than high school education

High school education or less

60 years and over

40–59 years

20–39 years‡

Women

Men†

Total

†

 Significant difference between men and women (p < 0.05). ‡

 Significant increasing linear trend by age (p < 0.001).

NOTES: With the exception of age group-specific percentages, estimates were age adjusted by the direct method to the 2000 U.S. Census population using the 

age groups 20–39, 40–59, and 60 and over. High BMI is defined as having a BMI greater than or equal to 25 kg/m2. Access data table for Figure 5 at: 

http://www.cdc.gov/nchs/data/databriefs/db140_table.pdf#5.

SOURCE: CDC/NCHS, National Health and Nutrition Examination Survey, 2011–2012.

Figure 5. Prevalence of high BMI among non-Hispanic Asian adults, by sex, age, education, and foreign-born status: 

United States, 2011–2012

38.6

43.0

34.7

30.3

44.6

43.3

44.0

37.6

37.9

45.1

Summary

Non-Hispanic Asian adults constituted 4.9% of the U.S. population in 2012, corresponding 

to 15.4 million people (2). This group primarily comprises persons of Chinese, Asian Indian, 

Korean, Filipino, Vietnamese, and Japanese descent.

The prevalence of hypertension (defined as having blood pressure greater than or equal to 140/90 

mm Hg or taking blood pressure-lowering medications) among non-Hispanic Asian adults aged 

20 and over was 25.6%. As previously reported, this prevalence is similar to that of non-Hispanic 

white adults and Hispanic adults but lower than that of non-Hispanic black adults (3). Among 

non-Hispanic Asian adults, the prevalence of hypertension was higher among those who were 

older or had less education, similar to findings in U.S. adults overall (4,5).

The prevalence of high total cholesterol (measured as cholesterol of at least 240 mg/dL) among 

non-Hispanic Asian adults was similar to that among adults of other race and Hispanic origin 

groups (6). Non-Hispanic Asian adults had a lower prevalence of low HDL cholesterol (measured 

as HDL less than 40 mg/dL) than Hispanic persons (6). Non-Hispanic Asian adult men were 

almost five times more likely than non-Hispanic Asian adult women to have low HDL cholesterol. 

While adult men in general are known to have a higher prevalence of low HDL cholesterol than 

adult women (7), the sex difference was larger than in other race and Hispanic origin groups (6).

The prevalence of high BMI among non-Hispanic Asian adults (38.6%) was much lower than that 

previously reported for non-Hispanic white adults (66.7%), non-Hispanic black adults (76.7%), 

and Hispanic adults (78.8%) (8). BMI is widely used as a measure of body fat. However, at a 

given BMI level, body fat may vary by sex, age, and race and Hispanic origin. In particular, at 
NCHS Data Brief ■ No. 140 ■ January 2014

■  6  ■

a given BMI, Asian adults may have more body fat than white adults (9). Also, morbidity and 

mortality risk may be influenced by body composition and fat distribution in a manner that is not 

completely captured by BMI (10).

This report builds on recently published estimates of hypertension, cholesterol, and obesity 

from NHANES 2011–2012 (3,6,11) by providing related estimates for Asian adults by select 

demographic characteristics. Hypertension, abnormal cholesterol levels, and elevated body 

weight are important risk factors for major chronic diseases, for which differences by race as 

well as ethnicity have been reported. The Asian population includes many ethnic groups, and the 

majority of non-Hispanic Asian adults in the United States are immigrants (12). Note that these 

estimates are for non-Hispanic Asian persons overall and may not reflect patterns for specific 

subgroups of Asian persons.

Definitions

Hypertension: Indicated by having systolic blood pressure greater than or equal to 140 mm Hg, 

having diastolic blood pressure greater than or equal to 90 mm Hg, or currently taking medication 

to lower high blood pressure.

High total cholesterol: Indicated by having serum total cholesterol equal to or greater than 240 

mg/dL.

Low HDL cholesterol: Indicated by having serum HDL cholesterol less than 40 mg/dL.

High BMI: Indicated by having a BMI (calculated as weight in kg divided by height in m2

) of 

greater than or equal to 25 kg/m2

.

Data source and methods

These analyses used NHANES data collected from 2011 through 2012. NHANES is a 

cross-sectional survey designed to monitor the health and nutritional status of the civilian 

noninstitutionalized U.S. population (13). The survey consists of interviews conducted in 

participants’ homes, standardized physical examinations conducted in mobile examination 

centers, and laboratory tests using blood and urine specimens provided by participants during the 

physical examination.

The NHANES sample is selected through a complex, multistage probability design that includes 

the selection of primary sampling units (counties), household segments within the counties, 

households within household segments, and sample persons from selected households. In 

2011–2012, non-Hispanic black, Hispanic, and non-Hispanic Asian persons were oversampled 

to obtain reliable estimates of health and nutritional measures for these population subgroups. 

In 1999, NHANES became a continuous survey fielded on an ongoing basis. Each year of data 

collection is based on a representative sample covering all ages of the civilian noninstitutionalized 

population. Public-use data files are released in 2-year cycles.

Race and Hispanic origin were self-reported during the home interview. This report analyzed 

the non-Hispanic Asian group. Participants who reported an Asian race and another race are not 

included in this category.
NCHS Data Brief ■ No. 140 ■ January 2014

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The estimation process incorporates sample weights, which account for the differential 

probabilities of selection, nonresponse, and noncoverage. Variance estimates were calculated 

using Taylor series linearization to account for the complex survey design. Pregnant women were 

excluded from the analyses for hypertension and high BMI.

Estimates of proportions by sex, age, education, and foreign-born status shown in Figure 1

were not age adjusted. Estimates of prevalence for hypertension, abnormal cholesterol, and 

high BMI, shown in Figures 2–5, were age adjusted using the direct method to the 2000 U.S. 

Census population with the age groups 20–39, 40–59, and 60 and over. Differences between 

groups were tested using the Wald test at the p < 0.05 significance level. All differences reported 

are statistically significant unless otherwise indicated. Adjustments were not made for multiple 

comparisons. Statistical analyses were conducted using Stata version 12.0 (College Station, Tex.).

About the authors

Yutaka Aoki, Sung Sug Yoon, Yinong Chong, and Margaret D. Carroll are with CDC’s National 

Center for Health Statistics, Division of Health and Nutrition Examination Surveys.

References

1. Hoeffel EM, Rastogi S, Kim MO, Shahid H. The Asian population: 2010. Washington, DC: 

U.S. Department of Commerce, Economics and Statistics Administration, U.S. Census Bureau. 

2012. Available from: http://www.census.gov/prod/cen2010/briefs/c2010br-11.pdf.

2. U.S. Census Bureau. 2012 American Community Survey 1-year estimates: DP05–ACS 

demographic and housing estimates. Washington, DC. Available from: http://factfinder2.census.

gov/bkmk/table/1.0/en/ACS/12_1YR/DP05.

3. Nwankwo T, Yoon SS, Burt V, Gu Q. Hypertension among adults in the United States: 

National Health and Nutrition Examination Survey, 2011–2012. NCHS data brief, no 133. 

Hyattsville, MD: National Center for Health Statistics. 2013. Available from: http://www.cdc.gov/

nchs/data/databriefs/db133.pdf.

4. Yoon SS, Burt V, Louis T, Carroll MD. Hypertension among adults in the United States, 

2009–2010. NCHS data brief, no 107. Hyattsville, MD: National Center for Health Statistics. 

2012. Available from: http://www.cdc.gov/nchs/data/databriefs/db107.pdf.

5. Keenan NL, Rosendorf KA. Prevalence of hypertension and controlled hypertension—United 

States, 2005–2008. MMWR Surveill Summ 60(Suppl):94–7. 2011.

6. Carroll MD, Kit BK, Lacher DA, Yoon SS. Total and high-density lipoprotein cholesterol in 

adults: National Health and Nutrition Examination Survey, 2011–2012. NCHS data brief, no 132. 

Hyattsville, MD: National Center for Health Statistics. 2013. Available from: http://www.cdc.gov/

nchs/data/databriefs/db132.pdf.

7. Carroll MD, Kit BK, Lacher DA. Total and high-density lipoprotein cholesterol in adults: 

National Health and Nutrition Examination Survey, 2009–2010. NCHS data brief, no 92. 

Hyattsville, MD: National Center for Health Statistics. 2012. Available from: http://www.cdc.gov/

nchs/data/databriefs/db92.pdf.
NCHS Data Brief ■ No. 140 ■ January 2014

8. Flegal KM, Carroll MD, Kit BK, Ogden CL. Prevalence of obesity and 

trends in the distribution of body mass index among U.S. adults, 1999–2010. 

JAMA 307(5):491–7. 2012. 

9. Deurenberg P, Deurenberg-Yap M, Guricci S. Asians are different from 

Caucasians and from each other in their body mass index/body fat per cent 

relationship. Obes Rev 3(3):141–6. 2002. 

10. Despres JP. Body fat distribution and risk of cardiovascular disease: An 

update. Circulation 126(10):1301–13. 2012. 

11. Ogden CL, Carroll MD, Kit BK, Flegal KM. Prevalence of obesity 

among adults: United States, 2011–2012. NCHS data brief, no 131. 

Hyattsville, MD: National Center for Health Statistics. 2013. Available from: 

http://www.cdc.gov/nchs/data/databriefs/db131.pdf.

12. Barnes PM, Adams PF, Powell-Griner E. Health characteristics of the 

Asian adult population: United States, 2004–2006. Advance data from vital 

and health statistics; no 394. Hyattsville, MD: National Center for Health 

Statistics. 2008. Available from: http://www.cdc.gov/nchs/data/ad/ad394.pdf.

13. National Center for Health Statistics. National Health and Nutrition 

Examination Survey. Questionnaires, datasets, and related documentation. 

Hyattsville, MD. Available from: http://www.cdc.gov/nchs/nhanes/nhanes_

questionnaires.htm.

Suggested citation

Aoki Y, Yoon SS, Chong Y, Carroll MD. 

Hypertension, abnormal cholesterol, and 

high body mass index among non-Hispanic 

Asian adults: United States, 2011–2012. 

NCHS data brief, no 140. Hyattsville, MD: 

National Center for Health Statistics. 2014.

Copyright information

All material appearing in this report is in 

the public domain and may be reproduced 

or copied without permission; citation as to 

source, however, is appreciated.

National Center for Health 

Statistics

Charles J. Rothwell, M.S., M.B.A., Director

Jennifer H. Madans, Ph.D., Associate 

Director for Science

Division of Health and Nutrition 

Examination Surveys

Kathryn S. Porter, M.D., M.S., Director

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