Abstract P474: The Association Between Acculturation and Cardiovascular Disease Risk Factors: The African Immigrant Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Ruth-alma N Turkson-ocran ◽  
Diana Baptiste ◽  
Oluwabunmi Ogungbe ◽  
Binu Koirala ◽  
Yvonne Commodore-mensah
Keyword(s):  
Risk Factors ◽  
Length Of Stay ◽  
Immigrant Health ◽  
African Immigrants ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Us ◽  
African Immigrant Health ◽  
The U.S

Introduction: African immigrants are a growing population with over 2.1 million residing in the United States (U.S). Like African Americans, their African descent counterparts, African immigrants have an increased risk of developing cardiovascular disease (CVD). Hypothesis: We hypothesized that greater length of residence in the U.S. will be associated with an increased number of CVD risk factors among African Immigrants. Methods: The African Immigrant Health Study was a cross-sectional study of African immigrants living in the Baltimore-Washington, D.C Metropolitan area. The main outcome of interest was high CVD risk, defined as the presence of ≥2 CVD risk factors including hypertension, diabetes, high cholesterol, and overweight/obesity. The secondary outcomes were the 4 CVD risk factors examined individually. The exposure was length of U.S. stay, used as a proxy for acculturation and defined as < 10 years or ≥ 10 years in the U.S. Logistic regression was used to examine the odds of high CVD risk and the individual CVD risk factors, adjusting for relevant covariates. Results: We included N=317 African immigrants, with mean(±se) age 48(±12) years, 61% were female, 63% had a Bachelor’s degree or higher, 81% were employed, and 59% had lived in the US ≥10 years. Unadjusted, African immigrants with longer length of stay were more likely to have the four CVD risk factors examined. African Immigrants who had lived in the U.S. ≥ 10 years were 1.89 times (95%CI: 1.03-3.46) more likely to have ≥2 CVD risk factors than those who had lived in the U.S. < 10 years after adjusting for age, income, employment status, insurance status, and routine place for healthcare. The unadjusted and adjusted results are presented in the Table. Conclusion: African immigrants who had lived in the US ≥10 years were more likely to have more CVD risk factors than those who had lived in the U.S. for <10 years. CVD risk increases with length of stay in this population, underscoring the need for length of stay to be considered as a meaningful determinant of CVD risk.

scholarly journals Discrimination Is Associated with Elevated Cardiovascular Disease Risk among African Immigrants in the African Immigrant Health Study

2020 ◽  
Vol 30 (4) ◽  
pp. 651-660
Author(s):  
Ruth-Alma N. Turkson-Ocran ◽  
Sarah L. Szanton ◽  
Lisa A. Cooper ◽  
Sherita H. Golden ◽  
Rexford S. Ahima ◽  
...  
Keyword(s):  
Risk Factors ◽  
Immigrant Health ◽  
African Immigrants ◽  
The United States ◽  
Health Study ◽  
Care Providers ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
African Immigrant ◽  
African Immigrant Health

Background: African Americans and other persons of African descent in the United States are disproportionately affected by cardiovascular diseases (CVD). Discrimi­nation is associated with higher CVD risk among US adults; however, this relationship is unknown among African immigrants.Objective: To examine the associations among discrimination, resilience, and CVD risk in African immigrants.Methods: The African Immigrant Health Study was a cross-sectional study of African immigrants in Baltimore-Washington, DC, with recruitment and data collection taking place between June 2017 and April 2019. The main outcome was elevated CVD risk, the presence of ≥3 CVD risk factors includ­ing hypertension, diabetes, high choles­terol, overweight/obesity, tobacco use, and poor diet. The secondary outcomes were these six individual CVD risk factors. The exposure was discrimination measured with the Everyday Discrimination Scale; summed scores ≥2 on each item indicated frequent experiences of discrimination. Resilience was assessed with the 10-item Connor- Davidson resilience scale. Logistic regression was used to examine the odds of elevated CVD risk, adjusting for relevant covariates.Results: We included 342 participants; 61% were females. The mean (±SD) age was 47(±11) years, 61% had at least a bachelor’s degree, 18% had an income <$40,000, and 49% had lived in the US ≥15 years. Persons with frequent experi­ences of discrimination were 1.82 times (95%CI: 1.04–3.21) more likely to have elevated CVD risk than those with fewer experiences. Resilience did not moderate the relationship between CVD risk and discrimination.Conclusion: African immigrants with frequent experiences of discrimination were more likely to have elevated CVD risk. Tar­geted and culturally appropriate interven­tions are needed to reduce the high burden of CVD risk in this population. Health care providers should be aware of discrimina­tion as a meaningful social determinant of CVD risk. At the societal level, policies and laws are needed to reduce the occurrence of discrimination among African immi­grants and racial/ethnic minorities. Ethn Dis. 2020;30(4):651-660;doi:10.18865/ed.30.4.651

Abstract P176: Cardiovascular Disease Risk among West African Immigrants in the US: the AFRO-CardiAC study

Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Yvonne Y Commodore-Mensah ◽  
Charles O Agyemang ◽  
Jonathan K Aboagye ◽  
Nancy Abu-Bonsrah ◽  
Cheryl R Himmelfarb
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Disease Risk ◽  
Cardiovascular Disease Risk ◽  
African Immigrants ◽  
West African ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
The Us ◽  
West African Immigrants

Introduction: There are research gaps on cardiovascular disease (CVD) risk of the burgeoning West-African immigrants (WAI) in the United States (US) because they are lumped into the racial category of “Black/African-American”. The epidemiological transition in Africa suggests that WAI may be at high risk for CVD prior to migration, which may worsen with increased years of US residence. We sought to examine the global CVD risk using the 10-year Framingham CVD score (FRS10), CVD risk factors and identify independent predictors of increased CVD risk, among WAI. Methods: The “AFRO-CardiAC” study is a community-based cross-sectional study among first generation WAI aged 35-74 years, born in Ghana/Nigeria and residing in the Washington, D.C metropolis. Cardiovascular disease risk factors (total cholesterol, HDL cholesterol, hypertension (HTN), diabetes, smoking and body mass index) and health behaviors were determined according to AHA guidelines. Descriptive statistics were performed on participant’s FRS10 and CVD risk factors with comparison by sex. Participants with FRS10 below 10% were deemed low risk and those at ≥ 10% were classified as high risk. A multivariate logistic regression was fitted to identify independent risk factors associated with high CVD risk. Results: A total of 145 participants have been recruited to date; aged 50±8.5years and 61% female. The majority (72%; 104/145) have resided in the US for more than 10 years. The overall prevalence of HTN was 53% with no significant difference between males (46%) and females (57%)[p=0.201]. The prevalence of overweight/obesity was 94% in females and 82% in males (p<0.0001). Only one participant reported smoking and 15% were diabetic, with no sex differences (males 20 % and females 12 %). Males had a significantly higher mean FRS10 (11.10±8.85) than females (6.66±6.48) [p=0.0016]. Also, 13%, 23%, 64% (n=56) of males were classified as having high, intermediate and low risk of CVD compared to 3%, 20%, and 77% of females (n=87)[p=0.082]. The predictors of high CVD risk using dichotomized FRS10 categories (<10% vs. ≥10%) as the outcome included increasing length of stay in the US, [Odds Ratio (OR):1.12, 95%CI: 1.04-1.20,p= 0.001], unemployment[OR:7.0, 95% CI: 1.69-29.79, p=0.008] and household income less than $25,000 (OR: 4.17, 95%CI:1.33-13.08,p=0.014) Conclusion: In conclusion, this preliminary analysis of an ongoing study shows a high prevalence of major CVD risk factors in relatively young WAI. Males had a significantly higher global CVD risk although females had a striking prevalence of overweight/obesity. Employment was protective against high CVD risk while lower income and longer stay in the US were associated with higher CVD risk. These data suggest a need for CVD prevention strategies that are tailored to the needs of the WAI with consideration of socioeconomic status and gender.

Abstract P006: Cardiovascular Disease Risk Factor Burden is Associated With Hearing Loss in Young Men: The Hispanic Community Health Study/Study of Latinos

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rachael R Baiduc ◽  
Brittany Bogle ◽  
Franklyn Gonzalez ◽  
Elizabeth Dinces ◽  
David J Lee ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Hearing Loss ◽  
Total Cholesterol ◽  
Young Women ◽  
Young Men ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Hispanic Community

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) <120/<80 mmHg; total cholesterol <180 mg/dL; not currently smoking; and not having prevalent diabetes. High CVD risk burden was defined as ≥ 2 of: diabetes; currently smoking; BP >160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL.

Abstract P354: The “Afro-Cardiac Study” Identifies High Burden of Cardiovascular Disease Risk in West African Immigrants in the United States

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Yvonne Y Commodore-Mensah ◽  
Charles A Berko ◽  
Maame E Sampah ◽  
Joycelyn Cudjoe ◽  
Cheryl D Himmelfarb
Keyword(s):  
Risk Factors ◽  
Social Support ◽  
Health Insurance ◽  
Vigorous Physical Activity ◽  
African Immigrants ◽  
The United States ◽  
West African ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
West African Immigrants

Introduction: The African immigrant population grew 40-fold between 1960 and 2007, from 35,355 to 1.4 million with one third coming from West Africa, primarily Ghana and Nigeria. African immigrants have been understudied and, traditionally, lumped into the racial category of Black/African-American. We have examined the prevalence of CVD risk factors (hypertension, overweight/obesity, diabetes, hyperlipidemia, current smoking and physical inactivity), assessed global CVD risk and identified independent predictors of increased CVD risk by sex in West African immigrants (WAI). Methods: Cross-sectional study of WAI (Ghanaians and Nigerians) aged 35-74 years recruited from churches in the Baltimore/ Washington, DC metropolitan area. CVD risk factors were determined per AHA guidelines. Descriptive statistics were performed on participant’s Pooled Cohort Equations (PCE) scores and CVD risk factors with comparison by sex. Participants with PCE scores ≥7.5% and ≥3 CVD risk factors were deemed high risk. A multivariable logistic regression was fitted to identify independent predictors of high CVD risk. Results: The mean age of the 253 participants was 49.5±9.2 years and 58% were female. Males were more likely to be employed than females (90% vs. 72%; p=0.001). Only 52% of participants had health insurance. The majority [54% [137/253)] had ≥3 CVD risk factors and 28% had PCE score ≥7.5%. Smoking was the least prevalent (<1%) and overweight/obesity the most prevalent (88%) risk factor. Although females (64%) were more likely to be treated for hypertension than males (36%), there was no difference in hypertension control by sex. Diabetes was identified in 16% of the participants. Mean total cholesterol (TC) was 180.9±33.9mg/dL and 32% had TC level ≥200mg/dL. In addition, 44% were found to be physically inactive (<150minutes/week of moderate or <75minutes/week of vigorous physical activity). In females, employment [0.18 AOR, 95%CI: 0.075-0.44)] and health insurance [0.35 AOR, 95%CI 0.14-0.87)] were associated with a PCE score ≥7.5%. In males, higher social support was associated with a 0.92 (95%CI: 0.84-0.98) odds of having ≥3 CVD risk factors. Conclusion: The high prevalence of CVD risk among relatively young WAIs is worrisome and suggests that the “healthy immigrant effect” may no longer hold for 21st century African immigrants. Employment and health insurance were protective against high CVD risk in females with social support protective against high CVD risk in males. CVD prevention strategies must be tailored to the unique needs of the WAI with consideration of socioeconomic status and sex.

Abstract P115: Relationship between Cardiovascular Risk Factors and Psychological Distress among Hispanic/Latinos: The Hispanic Community Health Study/ Study of Latinos

Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Sheila F Castaneda ◽  
Patricia Gonzalez ◽  
Linda C Gallo ◽  
Gregory A Talavera ◽  
Addie L Fortmann ◽  
...  
Keyword(s):  
Risk Factors ◽  
Psychological Distress ◽  
Depressive Symptomatology ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Sampling Weights ◽  
Hispanic Community ◽  
Unit Increase ◽  
Hispanic Latinos

Background: Studies show that cardiovascular disease (CVD) risk factors are correlated with psychological distress. Minimal research has been conducted exploring the relationship between psychological distress and CVD risk among Hispanic/ Latinos (H/L) of different background groups. The aim of this study was to investigate which CVD risk factors were most strongly correlated with psychological distress. Methods: The multi-site prospective population-based Hispanic Community Health Study/ Study of Latinos enrolled a cohort of H/L adults (n = 16,415) ages 18-74 in four US communities (Chicago, San Diego, Miami, and Bronx). Households were selected using a stratified two-stage probability sampling design and door-to-door recruitment, and sampling weights calibrated to the 2010 US Population Census. Analyses involve 15,464 participants with complete data. Psychological distress (i.e., 10-item Center for Epidemiological Studies Depression Scale and 10 item Spielberger Trait Anxiety Scale), socio-demographics (i.e., age, education, health insurance, gender, and H/L background), acculturation (i.e., years in the U.S., country of birth, and language), and CVD risk factors [i.e., dyslipidemia (HDL cholesterol < 40, LDL cholesterol ≥ 160,or triglycerides ≥ 200), body mass index (BMI), current cigarette smoking, diabetes (i.e., fasting time > 8 hr AND fasting glucose ≥ 126, or fasting time ≤ 8 hr AND fasting glucose ≥ 200, or post-OGTT glucose ≥ 200, or A1C≥ 6.5 or on medication), and hypertension (blood pressure ≥140/90 or on mediations)] were measured during the HCHS/SOL baseline exam. Associations between CVD risk factors and psychological distress were assessed using multiple linear regression models with depression and anxiety as dependent variables, accounting for the complex survey design and sampling weights, and controlling for socio-demographic and acculturation covariates. Results: Current smoking, diabetes, and BMI were significantly associated with depression and anxiety symptoms, after adjusting for covariates. Mean depressive symptomatology was 1.66 higher among smokers, .58 higher among diabetics, and increased by .04 for every one unit increase in BMI; mean anxiety symptomatology was 1.31 higher among smokers, .58 higher among diabetics, and increased by .05 for every one unit increase in BMI, adjusting for other factors. Dyslipidemia and hypertension were not associated with depression or anxiety. Discussion: Results demonstrate that certain CVD risk factors (i.e., smoking, diabetes, and BMI) were associated with psychological distress. Among the multiple CVD risk factors, current smoking was the strongest correlate; indicating its importance in CVD risk reduction among patients with depressive symptomatology.

Abstract P397: Social Determinants of Hypertension and Diabetes Among African Immigrants: The African Immigrant Health Study

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Oluwabunmi Ogungbe ◽  
Ruth-alma N Turkson-ocran ◽  
Diana Baptiste ◽  
Binu Koirala ◽  
Cheryl R Dennison Himmelfarb ◽  
...  
Keyword(s):  
Health Insurance ◽  
Marital Status ◽  
Social Determinants ◽  
Immigrant Health ◽  
Cardiovascular Health ◽  
African Immigrants ◽  
Health Study ◽  
Cross Sectional ◽  
African Immigrant ◽  
African Immigrant Health

Introduction: The differences in the risk of cardiovascular disease (CVD) among Black ethnic groups in the U.S. remain largely unexplained. African immigrants are particularly likely to have high rates of hypertension and diabetes, and less likely to be screened, diagnosed or receive treatment. Objective: To examine the association between social determinants of health (SDoH) and hypertension and diabetes among African immigrants. Methods: The African Immigrant Health Study was a cross-sectional study of 465 African immigrants living in the Baltimore-Washington metropolitan area. Data collection was performed through a combination of physical examinations and questionnaires. The outcomes were self-reported hypertension and diabetes. Elements of SDoH collected were education, income, health insurance, employment and marital status. Logistic regression analyses were used to assess the association between SDoH and hypertension/diabetes. Results: The mean age of participants was 46.8(±11.5) years and 60% were women; 64% had ≥ college degree, 83% were employed, 67% had health insurance, and 70% were married/co-habiting. Mean body mass index was 30.7 (±18.3) kg/m 2 . The prevalence of hypertension and diabetes was 32%, and 13% respectively. The odds of diabetes were higher amongst those who were unemployed [aOR: 2.86 (1.39-5.56)] ( Table ). Education, health insurance, income and marital status were not associated with hypertension or diabetes after accounting for age and sex. Conclusion: Among African immigrants, we observed that those who were unemployed had a higher likelihood of self-reported diabetes than those who were employed. Additional studies are needed to further study the contributions of social determinants of hypertension and diabetes as well as and developing health policy and interventions to improve cardiovascular health.

scholarly journals Risk factors for cardiovascular disease among Mexican-American adults in the United States and Mexico: a comparative study

2014 ◽  
Vol 56 (2) ◽  
pp. 197 ◽  
Author(s):  
Leo S Morales ◽  
Yvonne N Flores ◽  
Mei Leng ◽  
Noémie Sportiche ◽  
Katia Gallegos-Carrillo ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Mexican American ◽  
Hdl Cholesterol ◽  
The United States ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Men And Women ◽  
The Us ◽  
Low Hdl

 Objective. To compare cardiovascular disease (CVD) risk factors in a cohort of Mexican health workers with repre­sentative samples of US-born and Mexico-born Mexican-Americans living in the US. Materials and methods. Data were obtained from the Mexican Health Worker Cohort Study (MHWCS) in Mexico and the National Health and Nutrition Examination Survey (NHANES) IV 1999-2006 in the US. Regression analyses were used to investigate CVD risk factors. Results. In adjusted analyses, NHANES participants were more likely than MHWCS participants to have hypertension, high total cholesterol, diabetes, obesity, and abdominal obesity, and were less likely to have low HDL cholesterol and smoke. Less-educated men and women were more likely to have low HDL cholesterol, obesity, and ab­dominal obesity. Conclusions. In this binational study, men and women enrolled in the MHWCS appear to have fewer CVD risk factors than US-born and Mexico-born Mexican-American men and women living in the US.

scholarly journals Association between vegetarian diets and cardiovascular risk factors in non-Hispanic white participants of the Adventist Health Study-2

2019 ◽  
Vol 8 ◽  
Author(s):  
Seiji Matsumoto ◽  
W. Lawrence Beeson ◽  
David J. Shavlik ◽  
Gina Siapco ◽  
Karen Jaceldo-Siegl ◽  
...  
Keyword(s):  
Risk Factors ◽  
Ldl Cholesterol ◽  
Health Study ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Vegetarian Diets ◽  
Prevalence Ratios ◽  
White Adults ◽  
Hispanic White ◽  
Adventist Health Study

AbstractThe association between dietary patterns and CVD risk factors among non-Hispanic whites has not been fully studied. Data from 650 non-Hispanic white adults who participated in one of two clinical sub-studies (about 2 years after the baseline) of the Adventist Health Study-2 (AHS-2) were analysed. Four dietary patters were identified using a validated 204-item semi-quantitative FFQ completed at enrolment into AHS-2: vegans (8·3 %), lacto-ovo-vegetarians (44·3 %), pesco-vegetarians (10·6 %) and non-vegetarians (NV) (37·3 %). Dietary pattern-specific prevalence ratios (PR) of CVD risk factors were assessed adjusting for confounders with or without BMI as an additional covariable. The adjusted PR for hypertension, high total cholesterol and high LDL-cholesterol were lower in all three vegetarian groups. Among the lacto-ovo-vegetarians the PR were 0·57 (95 % CI 0·45, 0·73), 0·72 (95 % CI 0·59, 0·88) and 0·72 (95 % CI 0·58, 0·89), respectively, which remained significant after additionally adjusting for BMI. The vegans and the pesco-vegetarians had similar PR for hypertension at 0·46 (95 % CI 0·25, 0·83) and 0·62 (95 % CI 0·42, 0·91), respectively, but estimates were attenuated and marginally significant after adjustment for BMI. Compared with NV, the PR of obesity and abdominal adiposity, as well as other CVD risk factors, were significantly lower among the vegetarian groups. Similar results were found when limiting analyses to participants not being treated for CVD risk factors, with the vegans having the lowest mean BMI and waist circumference. Thus, compared with the diet of NV, vegetarian diets were associated with significantly lower levels of CVD risk factors among the non-Hispanic whites.

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