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

Abstract

BackgroundThe 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 ResultsThis 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%.ConclusionsThe 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.

Migration and Cardiovascular Disease Risk Among Ghanaian Populations in Europe:

“…Previous studies among many diverse migrant populations, including SSA migrants, have also shown high risk of physical inactivity among these populations, partly explaining their increased risk of CVD. 33,34 The effect of psychosocial The study also showed marked differences in risk of CVD between the cities of residence of European Ghanaian migrants, particularly in men. Elevated 10-year CVD risk among men was highest in Berlin (Germany) than Amsterdam (The Netherlands).…”

Expanding the Role of Nurses to Improve Hypertension Care and Control Globally

“…Commodore-Mensah et al 60,61 conducted a cross-sectional epidemiological study (N ¼ 253) to examine the association between acculturation and CVD risk factors, including hypertension, in the growing African immigrant population in the United States, which is often studied as a homogenous group with the dominant African-American population. Hypertension diagnosis, treatment, and control were 40%, 53%, and 50%, respectively, and prevalence of overweight and obesity was 88%.…”

Length of Residence in the United States is Associated With a Higher Prevalence of Cardiometabolic Risk Factors in Immigrants: A Contemporary Analysis of the National Health Interview Survey

“…However, immigrants have been found to have high levels of social support . Some studies have shown that high social support is associated with superior health outcomes among immigrants . Acculturation, a unique characteristic in immigrants, to some extent is associated with social support and the assimilation of immigrants to the host's sociocultural environment .…”

“…12,13 Some studies have shown that high social support is associated with superior health outcomes among immigrants. 14,15 Acculturation, a unique characteristic in immigrants, to some extent is associated with social support and the assimilation of immigrants to the host's sociocultural environment. 16 Acculturation is defined as "the dual process of cultural and psychological change that takes place as a result of contact between two or more cultures and their individual members."…”