Relationships of nativity and length of residence in the U.S. with favorable cardiovascular health among Hispanics/Latinos: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Abstract

Individuals with favorable levels of all readily measured major CVD risk factors (low CV risk) during middle age incur lower cardiovascular morbidity and mortality, lower all-cause mortality, and lower Medicare costs at older ages compared to adults with one or more unfavorable CVD risk factors. Studies on predictors of low CV risk in Hispanics/Latinos have focused solely on Mexican-Americans. The objective of this study was to use data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL; enrolled 2008 to 2011) to assess relationships of nativity and length of residence in the US, a commonly used proxy for acculturation, with low CV risk (not currently smoking; no diabetes; untreated total cholesterol <200mg/dL; untreated blood pressure<120/<80; body mass index <25kg/m2; and no major ECG abnormalities) in 15,047 Central American, South American, Cuban, Dominican, Mexican, Puerto Rican men and women, and Hispanic/Latino men and women identifying as other or >1 heritage. We also tested whether associations varied by Hispanic/Latino background. Women living in the US<10years were 1.96 (95% confidence interval: 1.37, 2.80) times more likely to be low CV risk than US-born women after adjusting for sociodemographic characteristics, diet, physical activity, and self-reported experiences of ethnic discrimination. Findings varied in men by Hispanic/Latino background, but length of residence was largely unrelated to low CV risk. These findings highlight the role acculturative processes play in shaping cardiovascular health in Hispanics/Latinos.