Abstract P350: Prevalence of Metabolic Risk Factors and Acculturation in Latinos: Results From Nhanes 1999-2012
INTRODUCTION: Prior research has shown that Latinos have a higher burden of metabolic risk factors compared to other racial/ethnic groups especially among those with a higher degree of acculturation to the US.
HYPOTHESIS: We hypothesize that patients with lower degrees of acculturation i.e. those that speak primarily Spanish and foreign born Latinos, are likely to have a lower prevalence of metabolic risk factors.
METHODS: Self-identified Latinos in the National Health and Nutrition Examination Survey (NHANES) from 1999 to 2012 were included. Prevalence of metabolic risk factors was defined using self-reporting, medication use and the following: hypertension (blood pressure >140/90 mmHg), diabetes (Hemoglobin A1c ≥6.5% or fasting plasma glucose ≥125 mg/dl), hyperlipidemia (total cholesterol ≥ 200mg/dl), obesity (Body Mass index≥30). Acculturation was measured by language, nativity and years in the US. Participant age, gender, smoking history, health insurance status, education level and poverty-income ratio were also included in the analyses. Chi-squared analyses and multivariable logistic regression models were used to examine the association of acculturation with metabolic risk factors prevalence adjusting for demographic, clinical variables and survey year.
RESULTS: A total of 23,693 participants were included. Prevalence of hypertension, diabetes, hyperlipidemia and obesity was 24.6%, 8.3%, 40.8%, and 26.1% respectively. Foreign born participants living in the US greater than 10 years had the highest rates of hypertension (37.8%), diabetes (19.0%), hyperlipidemia (61.3%) and obesity (34.9%). US born participants had the second highest prevalence of hypertension (29.8%), diabetes (5.6%) and obesity (18.6%) and lowest prevalence of hyperlipidemia (27.5%). In multivariable analyses, US born were more likely to be obese (OR 1.4 [1.2 - 1.5]) and hypertensive (OR 1.2 [1.1 - 1.5]), but less likely to have hyperlipidemia (OR 0.7 [0.6 - 0.8]) compared to foreign born. There was no significant difference in diabetes by nativity or language preference. Primarily Spanish speaking participants were less likely to be obese (OR 0.7 [0.6 - 0.8]) or hypertensive (OR 0.7 [0.6 - 0.9]) but had a higher likelihood of hyperlipidemia (OR 1.3 [1.1 - 1.5]). Among foreign born Latinos in the US, greater than 10 years compared to less years in the US, there was a higher likelihood of obesity (OR 1.7 [1.4 - 2.0]), diabetes (OR 1.4 [1.1 - 1.8]), and hyperlipidemia (OR 1.2 [1.0 - 1.5]) but no difference in hypertension (OR 1.1 [0.9 - 1.4]). These trends did not change significantly over time.
CONCLUSIONS: Contrary to prior studies, among foreign born Latinos prevalence of risk factors was highest among those with a greater number of years of US residence compared to those with fewer. Elucidating the mechanisms of acculturation’s impact on Latinos is essential for eliminating excess cardiovascular risk burden.
Author Disclosures: S.M. Khatana: None. F. Rodriguez: None. J.B. Meigs: None. B.C. Porneala: None. L. López: None.
- © 2015 by American Heart Association, Inc.