Abstract 047: Impact of Acculturation on Framingham Cardiovascular Risk Factors Among Elderly Mexican Americans

Abstract

Background: Acculturation is the process by which immigrant groups adopt the cultural practices and values of the host country. Higher levels of acculturation among Latinos have been shown to be associated with a higher prevalence of traditional CVD Framingham risk factors (FRFs) in some studies. The association of acculturation and prevalence of traditional CVD risk factors in elderly Latinos is less well established. Hypothesis: Higher acculturation is associated with higher CVD FRFs prevalence. Methods: We evaluated the association of acculturation with prevalence of FRF among 1,789 elderly men and women from the Sacramento Area Latino Study on Aging (SALSA) using multivariate linear and logistic regression. SALSA is a well-characterized, NIH funded cohort study of Mexican Americans aged > 60 followed since 1998–1999. Acculturation was measured using the validated bidimensional Acculturation Rating Scale for Mexican Americans-II and modeled as a continuous variable per interquantile range increase (IQR). We adjusted for age, gender, nativity status, income, insurance and the use of antihyperglycemic and antihypertensive medications. To evaluate whether differences in behavior may mediate the association of acculturation and FRFs we further adjusted for social and behavioral factors (marital status, physical activity, smoking, alcohol). We tested for the interaction of acculturation with FRF by nativity status. Results: Median age was 69.8 ± 7.1 and the overall IQR was 24 points. The mean acculturation score for US born Mexican Americans was 30.7 ±9.9 compared to 13.5 ± 9.4 for foreign born (p<0.001). Higher acculturation was associated with lower SBP (beta −1.79, 95%CI [−3.55, −0.02] per IQR increase in acculturation score) and lower LDL (beta −3.59, 95% CI [−6.79, −0.39] per IQR increase in acculturation score) after age and sex adjustment. Acculturation was not associated with total cholesterol, HDL, DM, BMI or smoking (all p values >0.05). The association of acculturation and SBP was attenuated after adjustment (beta −0.90, 95% CI [−2.99, 1.19] per IQR increase in acculturation score. Higher acculturation remained associated with lower LDL levels (β=−4.82, 95% CI [−8.7, −0.9] per IQR increase in acculturation score) after full adjustment. Stratification by nativity status did not affect these results. Conclusions: Contrary to other reports in middle-aged persons, higher levels of acculturation were associated with lower LDL and not higher prevalence of CVD FRFs in a large cohort of elderly Mexican Americans. The effect of acculturation in CVD risk factors may differ across the life course.