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

• Type of Material: Article
• Authors: Yvonne Commodore Mensah, Emory University; Martha Hill, Johns Hopkins University School of Nursing; Jerilyn Allen, Johns Hopkins University School of Nursing; Lisa A. Cooper, Johns Hopkins University School of Nursing; Roger Blumenthal, Johns Hopkins University School of Nursing; Charles Agyemang, University of Amsterdam; Cheryl Dennison Himmelfarb, Johns Hopkins University School of Nursing
• Language: English
• Date: 2016
• Publisher: American Heart Association: JAHA
• Publication Version: Final Published Version
• Copyright Statement: © 2016 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley Blackwell.
• License: Creative Commons Attribution 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1161/JAHA.115.002385
• Title of Journal or Parent Work: Journal of the American Heart Association
• ISSN: 2047-9980
• Volume: 5
• Issue: 2
• Start Page: e002385
• End Page: e002385
• Grant/Funding Information: This study was funded by the Center for Excellence in Cardiovascular Health National Institute of Nursing Research pilot grant P30NR011409.
• Keywords: African immigrants; migrant health; cardiovascular disease
• Research Categories: Health Sciences, Public Health; Health Sciences, Nursing

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/m(2)) ≥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.