Abstract 19385: The Paradoxical Association Between Acculturation and Cardiovascular Disease Risk in African Immigrants in the United States: The Afro-Cardiac Study
Introduction: The burden of cardiovascular disease (CVD) risk in ethnic minorities in the United States (US) is high. Acculturation is associated with elevation or reduction of CVD risk in Hispanic and Asian immigrants. However, this relationship is unknown in African immigrants.
Hypothesis: We hypothesized that acculturation (length of US residence and acculturation classification) would be associated with elevated CVD risk (≥3 CVD risk factors or Pooled Cohort Equations score ≥ 7.5%) in African immigrants with significant differences by sex.
Methods: African immigrants (n=253) residing in Baltimore-Washington, D.C were sampled. We obtained fasting lipid and glucose levels, blood pressure, anthropometric measures and administered a questionnaire. Acculturation classifications were Integrationists (identified equally with the American and African cultures), Traditionalists (identified more with the African than American culture), Marginalists (identified with neither the American nor African cultures) and Assimilationists (identified more with the American than African culture). Analyses included sex-specific unadjusted and adjusted logistic regression analyses.
Results: Mean age was 49.5±9.2 years, and 58% were female. The mean length of US residence was 13.6±8.8 years. Residing in the US for ≥10 years was associated with 5-fold (95%CI: 1.28, 20.33) and 8-fold (95%CI: 2.09, 30.80) odds of overweight/obesity and elevated CVD risk (PCE scores ≥7.5%) respectively in males. Females residing in the US for ≥10 years were 2.60 times (95%CI: 1.04, 6.551) more likely to be hypertensive than newer residents. Acculturation classifications were: Integrationists, 166(66%); Traditionalists, 80(32%); Marginalists, 5(2%); and Assimilationists, 2(1%). Integrationists had a 0.49(95%CI: 0.26, 0.93) lower odds of having ≥3 CVD risk factors and 0.46(95%CI: 0.23, 0.91) lower odds of having elevated CVD risk than Traditionalists.
Conclusions: The paradoxical finding of lower CVD risk despite longer years of residence in Integrationists compared to Traditionalists is unique. Knowledge of acculturation status of African immigrants would guide health providers to deliver more culturally appropriate preventive care.
Author Disclosures: Y.Y. Commodore-Mensah: None. C.D. Himmelfarb: None. C.M. Reilly: None. S.B. Dunbar: None.
- © 2016 by American Heart Association, Inc.