Abstract P159: The Impact of Acculturation on Ideal Cardiovascular Health Metrics Among Hispanic Adults: Results from the National and Nutrition Examination Survey 1999-2010

Abstract

Background: The American Heart Association has identified a set of 7 ideal health metrics that are associated with reduced cardiovascular disease mortality. Higher acculturation has been linked to increased risk of cardiovascular disease risk factors among Hispanics. We tested whether acculturation is associated with these ideal metrics in a large contemporary sample of Hispanic adults. Methods: We examined the association between acculturation and 7 ideal cardiovascular health metrics in the National Health and Nutrition Examination Survey (NHANES) from 1999-2010. Acculturation was measured by language use, with higher acculturation defined as the use of at least equal English and Spanish. The 7 ideal health metrics included not smoking, a body mass index (BMI) <25 kg/m2, moderate intensity exercise (defined by weekly METs), a healthy diet (healthy diet score ≥2), and maintenance of normal values of cholesterol (<200 mg/dL), fasting glucose (<100 mg/dL), and blood pressure (<120/<80 mm Hg). Based on established guidelines, components were defined as poor, intermediate, or ideal. Chi-squared analyses and logistic regression models were used to examine the independent association between ideal health metrics and acculturation, adjusting for age, gender, insurance status, usual place of care and appropriate sampling weights. P values ≤ 0.05 were significant. Results: The study sample consisted of 8,707 Hispanic adults. As compared with more acculturated adults, less acculturated adults were slightly older (mean age 41.1 vs. 39.2, p=0.004), were more likely to have less than a high school education (67.1 vs. 25.1%, p<0.001), less likely to have a usual source of care (61.3 vs. 79.1%, p<0.001) and more likely to be uninsured (57.0 vs. 27.4%, p<0.001). Less acculturated Hispanics were more likely to be nonsmokers (64.0 vs. 54.7%, p<0.001) but were less likely to meet ideal health metrics for BMI, physical activity, cholesterol, and glycemic control as compared with more acculturated adults. There was no difference in the healthy diet score by acculturation. In a subset of participants with all 6 ideal health metrics (N=1516) excluding diet, lower acculturation was associated with a trend for higher odds of having 6 of the ideal health metrics in fully adjusted models (Odds Ratio 1.8 [95% CI 1.0-3.1]). Conclusion: Contrary to prior reports of the positive health effects of low acculturation, we found that lower acculturation is associated with poor cardiovascular health metrics in a national sample of Hispanic adults. However, this group is also heterogeneous and future studies should explore the complex role of acculturation in cardiovascular disease risk profiles.