Cardiovascular Disease Risk and the Association with Acculturation in West African Immigrants in the United States
Commodore-Mensah, Yvonne Yarkor
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Background: Cardiovascular disease (CVD) is a leading cause of morbidity and mortality in the United States (US). Despite substantial reduction in CVD events of Americans, many ethnic minorities experience striking CVD disparities, with insufficient research to explain these disparities. Limited research conducted in West African Immigrants (WAI), specifically Ghanaian and Nigerian immigrants residing in other high-income countries has revealed a high prevalence of CVD risk factors. However, no epidemiological studies have explored CVD risk and the association with behavioral, social, economic and cultural factors in African immigrants in the US. Design and Methods: : Cross-sectional study epidemiological of West African immigrants (Ghanaian and Nigerian-born ) aged 35–74 years residing in the Baltimore, Washington-D.C metropolitan area. A full fasting lipid-profile, glucose concentrations, blood pressure and anthropometric measured were obtained and a modified World Health Organization questionnaire with items assessing social support, CVD knowledge and acculturation was administered to participants. Findings: 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%) had ≥3 CVD risk factors and 28% had PARS10 ≥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. Also, 44% were found to be physically inactive. 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 PARS10 ≥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. Conclusions: The healthy immigrant effect may not hold for this current generation of African immigrants. Larger studies are need to confirm the relationships between predisposing, reinforcing and enabling factors and CVD risk as well as the association between acculturation and CVD risk identified in this study.