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Sex Differences in Cardiovascular Disease Risk of Ghanaian‐ and Nigerian‐Born West African Immigrants in the United States: The Afro‐Cardiac Study

Identifieur interne : 000049 ( Pmc/Curation ); précédent : 000048; suivant : 000050

Sex Differences in Cardiovascular Disease Risk of Ghanaian‐ and Nigerian‐Born West African Immigrants in the United States: The Afro‐Cardiac Study

Auteurs : Yvonne Commodore-Mensah ; Martha Hill ; Jerilyn Allen ; Lisa A. Cooper ; Roger Blumenthal ; Charles Agyemang ; Cheryl Dennison Himmelfarb

Source :

RBID : PMC:4802474

Abstract

Background

The number of African immigrants in the United States grew 40‐fold between 1960 and 2007, from 35 355 to 1.4 million, with a large majority from West Africa. This study sought to examine the prevalence of cardiovascular disease (CVD) risk factors and global CVD risk and to identify independent predictors of increased CVD risk among West African immigrants in the United States.

Methods and Results

This cross‐sectional study assessed West African (Ghanaian and Nigerian) immigrants aged 35–74 years in the Baltimore–Washington metropolitan area. The mean age of participants was 49.5±9.2 years, and 58% were female. The majority (95%) had ≥1 of the 6 CVD risk factors. Smoking was least prevalent, and overweight or obesity was most prevalent, with 88% having a body mass index (in  kg/m2) ≥25; 16% had a prior diagnosis of diabetes or had fasting blood glucose levels ≥126 mg/dL. In addition, 44% were physically inactive. Among women, employment and health insurance were associated with odds of 0.09 (95% CI 0.033–0.29) and 0.25 (95% CI 0.09–0.67), respectively, of having a Pooled Cohort Equations estimate ≥7.5% in the multivariable logistic regression analysis. Among men, higher social support was associated with 0.90 (95% CI 0.83–0.98) lower odds of having ≥3 CVD risk factors but not with having a Pooled Cohort Equations estimate ≥7.5%.

Conclusions

The prevalence of CVD risk factors among West African immigrants was particularly high. Being employed and having health insurance were associated with lower CVD risk in women, but only higher social support was associated with lower CVD risk in men.


Url:
DOI: 10.1161/JAHA.115.002385
PubMed: 26896477
PubMed Central: 4802474

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PMC:4802474

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<alt-title alt-title-type="left-running-head">Commodore‐Mensah et al</alt-title>
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<name>
<surname>Commodore‐Mensah</surname>
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<degrees>PhD, RN</degrees>
<xref ref-type="aff" rid="jah31336-aff-0001">
<sup>1</sup>
</xref>
</contrib>
<contrib id="jah31336-cr-0002" contrib-type="author">
<name>
<surname>Hill</surname>
<given-names>Martha</given-names>
</name>
<degrees>PhD, RN</degrees>
<xref ref-type="aff" rid="jah31336-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="jah31336-cr-0003" contrib-type="author">
<name>
<surname>Allen</surname>
<given-names>Jerilyn</given-names>
</name>
<degrees>ScD, RN</degrees>
<xref ref-type="aff" rid="jah31336-aff-0002">
<sup>2</sup>
</xref>
</contrib>
<contrib id="jah31336-cr-0004" contrib-type="author">
<name>
<surname>Cooper</surname>
<given-names>Lisa A.</given-names>
</name>
<degrees>MD, MPH</degrees>
<xref ref-type="aff" rid="jah31336-aff-0003">
<sup>3</sup>
</xref>
</contrib>
<contrib id="jah31336-cr-0005" contrib-type="author">
<name>
<surname>Blumenthal</surname>
<given-names>Roger</given-names>
</name>
<degrees>MD</degrees>
<xref ref-type="aff" rid="jah31336-aff-0003">
<sup>3</sup>
</xref>
</contrib>
<contrib id="jah31336-cr-0006" contrib-type="author">
<name>
<surname>Agyemang</surname>
<given-names>Charles</given-names>
</name>
<degrees>PhD, MPH</degrees>
<xref ref-type="aff" rid="jah31336-aff-0004">
<sup>4</sup>
</xref>
</contrib>
<contrib id="jah31336-cr-0007" contrib-type="author">
<name>
<surname>Himmelfarb</surname>
<given-names>Cheryl Dennison</given-names>
</name>
<degrees>PhD, ANP, RN</degrees>
<xref ref-type="aff" rid="jah31336-aff-0002">
<sup>2</sup>
</xref>
</contrib>
</contrib-group>
<aff id="jah31336-aff-0001">
<label>
<sup>1</sup>
</label>
<named-content content-type="organisation-division">Emory University</named-content>
<institution>Nell Hodgson Woodruff School of Nursing</institution>
<named-content content-type="city">Atlanta</named-content>
<named-content content-type="country-part">GA</named-content>
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<label>
<sup>2</sup>
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<institution>Johns Hopkins University School of Nursing</institution>
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</aff>
<aff id="jah31336-aff-0003">
<label>
<sup>3</sup>
</label>
<institution>Johns Hopkins School of Medicine</institution>
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</aff>
<aff id="jah31336-aff-0004">
<label>
<sup>4</sup>
</label>
<named-content content-type="organisation-division">Department of Public Health</named-content>
<institution>Academic Medical Centre/University of Amsterdam</institution>
<country country="NL">The Netherlands</country>
</aff>
<author-notes>
<corresp id="correspondenceTo">
<label>*</label>
<bold>Correspondence to:</bold>
Yvonne Commodore‐Mensah, PhD, RN, Nell Hodgson Woodruff School of Nursing, Emory University, 1520 Clifton Road NE, Rm 368, Atlanta, GA 30322‐4027. E‐mail:
<email>ycommod@emory.edu</email>
</corresp>
</author-notes>
<pub-date pub-type="epub">
<day>18</day>
<month>2</month>
<year>2016</year>
</pub-date>
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<month>2</month>
<year>2016</year>
</pub-date>
<volume>5</volume>
<issue>2</issue>
<issue-id pub-id-type="doi">10.1002/jah3.2016.5.issue-2</issue-id>
<elocation-id>e002385</elocation-id>
<history>
<date date-type="received">
<day>09</day>
<month>7</month>
<year>2015</year>
</date>
<date date-type="accepted">
<day>06</day>
<month>1</month>
<year>2016</year>
</date>
</history>
<permissions>
<pmc-comment> Copyright © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell </pmc-comment>
<copyright-statement content-type="article-copyright">© 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.</copyright-statement>
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License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.</license-p>
</license>
</permissions>
<self-uri content-type="pdf" xlink:type="simple" xlink:href="file:JAH3-5-e002385.pdf"></self-uri>
<abstract id="jah31336-abs-0001">
<sec id="jah31336-sec-0001">
<title>Background</title>
<p>The number of African immigrants in the United States grew 40‐fold between 1960 and 2007, from 35 355 to 1.4 million, with a large majority from West Africa. This study sought to examine the prevalence of cardiovascular disease (
<styled-content style="fixed-case">CVD</styled-content>
) risk factors and global
<styled-content style="fixed-case">CVD</styled-content>
risk and to identify independent predictors of increased
<styled-content style="fixed-case">CVD</styled-content>
risk among West African immigrants in the United States.</p>
</sec>
<sec id="jah31336-sec-0002">
<title>Methods and Results</title>
<p>This cross‐sectional study assessed West African (Ghanaian and Nigerian) immigrants aged 35–74 years in the Baltimore–Washington metropolitan area. The mean age of participants was 49.5±9.2 years, and 58% were female. The majority (95%) had ≥1 of the 6
<styled-content style="fixed-case">CVD</styled-content>
risk factors. Smoking was least prevalent, and overweight or obesity was most prevalent, with 88% having a body mass index (in  kg/m
<sup>2</sup>
) ≥25; 16% had a prior diagnosis of diabetes or had fasting blood glucose levels ≥126 mg/
<styled-content style="fixed-case">dL</styled-content>
. In addition, 44% were physically inactive. Among women, employment and health insurance were associated with odds of 0.09 (95%
<styled-content style="fixed-case">CI</styled-content>
0.033–0.29) and 0.25 (95%
<styled-content style="fixed-case">CI</styled-content>
0.09–0.67), respectively, of having a Pooled Cohort Equations estimate ≥7.5% in the multivariable logistic regression analysis. Among men, higher social support was associated with 0.90 (95%
<styled-content style="fixed-case">CI</styled-content>
0.83–0.98) lower odds of having ≥3
<styled-content style="fixed-case">CVD</styled-content>
risk factors but not with having a Pooled Cohort Equations estimate ≥7.5%.</p>
</sec>
<sec id="jah31336-sec-0003">
<title>Conclusions</title>
<p>The prevalence of
<styled-content style="fixed-case">CVD</styled-content>
risk factors among West African immigrants was particularly high. Being employed and having health insurance were associated with lower
<styled-content style="fixed-case">CVD</styled-content>
risk in women, but only higher social support was associated with lower
<styled-content style="fixed-case">CVD</styled-content>
risk in men.</p>
</sec>
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<notes>
<p content-type="self-citation">
<mixed-citation publication-type="journal" id="jah31336-cit-1001">(
<source>J Am Heart Assoc</source>
.
<year>2016</year>
;
<volume>5</volume>
:e002385 doi:
<ext-link ext-link-type="doi" xlink:href="10.1161/JAHA.115.002385">10.1161/JAHA.115.002385</ext-link>
)</mixed-citation>
</p>
</notes>
</front>
</pmc>
</record>

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