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AJPH First Look, published online ahead of print May 29, 2008
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American Journal of Public Health, 10.2105/AJPH.2007.123844

Research and Practice

Associations of Acculturation and Socioeconomic Status With Subclinical Cardiovascular Disease in the Multi-Ethnic Study of Atherosclerosis

Pamela L. Lutsey 1, Ana V. Diez Roux 2, David R. Jacobs Jr 1, Gregory L. Burke 3, Jane Harman 4, Steven Shea 5, Aaron R. Folsom 1*

1 University of Minnesota
2 University of Michigan
3 Wake Forest University
4 National Heart Blood and Lung Institute
5 Columbia University

* To whom correspondence should be addressed. E-mail: folsom{at}epi.umn.edu.


  Abstract

Objectives. We assessed whether markers of acculturation (birthplace and number of US generations) and socioeconomic status (SES) are associated with markers of subclinical cardiovascular disease—carotid artery plaque, internal carotid intima-media thickness, and albuminuria—in 4 racial/ethnic groups.

Methods. With data from the Multi-Ethnic Study of Atherosclerosis (n=6716 participants aged 45–84 years)and race-specific binomial regression models,we computed prevalence ratios adjusted for demographics and traditional cardiovascular risk factors.

Results. The adjusted US- to foreign-born prevalence ratio for carotid plaque was 1.20 (99% confidence interval [CI]=0.97, 1.39) among Whites, 1.91 (99% CI=0.94, 2.94) among Chinese, 1.62 (99% CI=1.28, 2.06) among Blacks, and 1.23 (99% CI=1.15, 1.31) among Hispanics. Greater carotid plaque prevalence was found among Whites, Blacks, and Hispanics with a greater number of generations with US residence (P<.001) and among Whites with less education and among Blacks with lower incomes. Similar associations were observed with intima-media thickness. There was also evidence of an inverse association between albuminuria and SES among Whites and Hispanics.

Conclusions. Greater US acculturation and lower SES were associated with a higher prevalence of carotid plaque and greater intima-media thickness but not with albuminuria. Maintenance of healthful habits among recent immigrants should be encouraged.

Key Words: Cardiovascular Disease, Epidemiology, Immigration, Race/Ethnicity, Socioeconomic Factors




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