Afro Caribbean Research Articles

Abstract P443: Alcohol Use Prevalence Among US Born and Foreign-Born Black Adults in the 2010 to 2018 National Health Interview Survey

Background: Alcohol use is an important risk factor for CVD, but variations among Black adults are not well known. We aimed to examine differences in alcohol use among Black subgroups. Hypothesis: Foreign-born Black adults will exhibit less alcohol use than their native-born peers. Methods: We performed a cross-sectional analysis of pooled data from the 2010 to 2018 National Health Interview Survey. Exposure was Black subethnic categories; African American (AA), African Immigrant (AI), and Afro-Caribbean (AC) adults; with non-Hispanic U.S. born White adults as the reference group. The outcome was self-reported alcohol use, categorized as never, former, or current drinker. Survey-weighted multinomial logistic regression was used to examine the relative risk ratios of alcohol use adjusting for covariates. Results: We included 415,250 White adults and 84,709 Black adults. Of those, 73,893 (87.2%) were AA, 6,739 (8.0%) were AC, and 4,077(4.8%) were AI. After adjusting for age, sex, marital status, education, employment, income, and insurance, the prevalence rates of current drinking were 68.3, 32.5, 48.1, and 57.1 for White, AI, AC, and AA, respectively. The odds of never drinker and former drinker compared to current drinker were higher among all Black groups than White adults. AI. were more likely to be never drinkers (RRR: 9.48; 95% CI: 8.10-11.10) followed by AC (RRR:3.70 95% CI: 3.22-4.24) and AA (RRR: 1.91 95% CI: 1.81-2.01). Conclusion: Black adults are less likely to be current alcohol drinkers when compared to White adults. However, there is significant variation in alcohol usage within the Black population by region of origin. These findings highlight the need for further intra-race evaluation into the underlying causes of alcohol use differences.

Simultaneous initiation of quadruple therapy for heart failure with reduced ejection fraction: initial experience in Afro Caribbean Jamaican population

Background: Among Afro Caribbean Jamaican patients with heart failure with reduced ejection fraction (HFrEF), improvements in cardiac function associated with simultaneous initiation of quadruple therapy, have not been previously reported and we aimed to assess this special population. Methods: Combined quadruple therapy (angiotensin-receptor neprilysin inhibitor, beta-blocker, mineralocorticoid receptor antagonist, and Sodium-glucose cotransporter-2 inhibitors) was simultaneously initiated in 120 Afro Jamaican patients with HFrEF from the Heart Institute of the Caribbean. Patient data was consecutively recorded in our electronic medical records. Changes in Ejection fraction (EF) and N-terminal pro b-type natriuretic peptide (NT-ProBNP) levels, were evaluated after 90 days and statistically analysed during this two-year study. Results: Patient mean age was 63 ± 12.7 years old, 68% male, with mean Body Mass index (BMI) 32.2±6.7 Kg/m2. Hypertension was observed in 62.5 %, T2Diabetes Mellitus in 31.7%, and history of old myocardial infarction in 15.7 %. Atrial fibrillation was present in 7.8% and left bundle branch block in 16.5 %. Other cardiomyopathies (idiopathic, peripartum and non-compaction) were noted in 16.6 %. After the quadruple therapy for a median follow-up period of 90 days, significant improvements of cardiac function were achieved. The mean NT pro-BNP level was significantly decreased from a Baseline of 3111.21 pg/mL ± 4535 to 1806.6 ± 2265.3 pg/ml. A mean change in NT Pro BNP of 1305 pg/mL ± 5069 (p < 0.001). The mean left ventricle ejection fraction (LVEF) improved from a baseline of 33.4 % ± 7.8 to 44.4 % ± 10.9. A mean change in LVEF of 11.3% ± 9.1 (p <0.001). Notably, an improvement of >10% in the LVEF was observed in 41.5% of the total population. In a separate analysis, the subgroup with T2 Diabetes mellitus showed more pronounced (mean change in EF 9.1% ± 11.0) improvement in LVEF than the non-diabetic (mean change in EF 7.7% ± 11.7) but no significant differences in the change of the NT pro-BNP levels were noted between both subgroups. The most frequent therapy adverse effect was hypotension (13.63%) followed by cough (6.81%) and kidney dysfunction (2.27%) but none of the patients presented Angioedema. Conclusion: Among Afro Caribbean Jamaican patients with heart failure and reduced ejection fraction, simultaneous initiation of the quadruple therapy was demonstrated to be feasible, well tolerated and associated with significant functional improvement.

Honoring Our Caribbean Ancestors: Commemorating 150 years of the Second Wave of People of African Descent in Costa Rica

El año 2022 conmemora 150 años de la migración de personas afrodescendientes para la construcción del ferrocarril en Costa Rica a finales del siglo XIX y más tarde a inicios del siglo XX en las plantaciones de banano. Lamentablemente dentro de la historia general los nombres e historias de las personas quienes contribuyen con el desarrollo de estos países sean nacionales o extranjeros y en especial si estos no son parte del grupo étnico hegemónico, en la mayoría de los casos son ignorados. Los inmigrantes de finales del siglo XIX no son la excepción. El objetivo de este artículo es el de traer al imaginario del colectivo costarricense siete nombres de individuos/a Afrocaribeños y una familia quienes contribuyeron al desarrollo económico, cultural y reproductivo de este país, honrándoles, visibilizándoles por medio de la memoria. Este artículo recoge historia oral entre enero y marzo del 2022, la revisión y análisis de periódicos además de otras publicaciones.

Breast Carcinoma Receptor Expression in a Caribbean Population.

Trinidad and Tobago are islands in the Southern Caribbean with a unique mix of races within the population consisting of East Indian (EI) (37.6%), Afro-Caribbean (AC) (36.3%), mixed (24.2%), and Caucasian, Chinese, Lebanese, Syrian, Amerindian, and Spanish groups accounting for 1.9%. It makes it suitable for a comparison of breast carcinoma receptor expression within a fixed environment. This study included 257 women with an age range of 28 to 93 years (mean = 57.2, standard deviation = 15.0), peak age group of 51 to 60 consisting of 105 EI, 119 AC, and 33 mixed descent. Invasive ductal carcinoma accounted for 88%, invasive lobular 9.7%, and ductal carcinoma in situ 2.3%. The triple-negative rates were 24.8, 33.6, and 30.3% for EI, AC, and mixed races, respectively, with the Pearson's chi-square test revealing statistical significance for the AC versus EI ( p < 0.001); AC versus mixed ( p < 0.001); and EI versus mixed ( p = 0.014) groups. The overall estrogen (ER), progesterone (PR), and human epidermal growth receptor (HER) expression negative rates were 52, 64, and 79%, respectively. Chi-square test of the following combinations: ER +/PR +/HER + ; ER +/PR +/HER − ; ER −/PR −/HER + ; ER +/PR −/HER + ; ER +/PR −/HER − ; ER −/PR +/HER + ; ER −/PR +/HER− revealed no statistical differences ( p = 0.689).

Profiles of substance use related protective and risk factors and their associations with alcohol and tobacco use initiation among black adolescents

Insufficient attention to protective and risk factors of particular salience for Black youth (e.g., racial identity and racial discrimination) in population-based substance use studies has left gaps in our understanding of alcohol and tobacco use development in Black adolescents. The current study aimed to capture the clustering of such understudied factors and their collective influence on alcohol and tobacco use initiation among Black adolescents. Data were drawn from The National Survey of American Life (n = 1,170; age range = 13-17; 6.9% Afro Caribbean, 93.1% African American; 50.0% female). Latent profile analysis applied to 11 indicators representing family, community, and individual level protective and risk factors revealed (1) High Vulnerability (high risk, low protective factors; 17.5%), (2) Moderate Vulnerability (moderate on both; 63.2%), and (3) Low Vulnerability (high protective, low risk factors; 19.3%) classes. Classes differed significantly by religious community support, school bonding, quality of relationship with mother, religious involvement, and interpersonal trauma. Relative to Class 2, Class 1 had higher odds of alcohol (OR = 1.518, CI:1.092-2.109) and tobacco use (OR = 1.998, CI:1.401-2.848); Class 3 had lower odds of alcohol (OR = 0.659, CI:0.449-0.968) but not tobacco use (OR = 0.965, CI:0.611-1.523). Findings suggest that alcohol and tobacco use initiation among Black adolescents is shaped by the collective influence of community and family level support, with commonly experienced risk factors such as non-interpersonal trauma distinguishing liability to a lesser degree. The equally modest prevalence of tobacco use among low and moderate vulnerability classes further indicates that fostering these connections may be especially effective in reducing tobacco use risk.

Not Just Service Attendance: Associations of Religious Community Social Connections with Alcohol Use among Black Adults Header: Religious Community Social Connections and Alcohol Use among Black Adults

ABSTRACT Background: Religious involvement is a well-documented protective factor against alcohol use among Black adults, but the extent to which social connections to the religious community can explain those effects remains largely unknown. The current study was designed to capture contributions of religious community support and demands – independent of religious service attendance – to alcohol use among three age cohorts of Black adults. Methods: Data were drawn from 18- to 65-year-old Black participants in the National Survey of American Life (n = 4,462; 29.4% Afro Caribbean, 70.6% African American; 63.20% female). Ordinal logistic regression analyses, conducted separately for each age cohort (18-29, 30-44, and 45-65), were used to model frequency of alcohol use as a function of religious community support and demands in two stages: (1) prior to and (2) after accounting for religious service attendance. Results: Religious community support accounted for differences in alcohol use frequency over and above religious service attendance (in Stage 2 models) for adults aged 30-44 (OR = 0.85, CI: 0.74-0.96) and 45-65 (OR = 0.77, CI: 0.64-0.93) but not 18-29 (OR = 0.85, CI: 0.71-1.03). The association of religious community demands with alcohol use frequency was specific to the age 30-44 cohort in both stage models (Stage 2: OR = 1.33, CI: 1.06-1.68). Conclusions: Study findings suggest that in addition to attending religious services regularly, developing supportive social connections to the religious community may reduce risk for frequent drinking among Black adults, particularly during middle adulthood, when demands from the religious community may increase risk.

Syncope as a Long Term Effect of Coronavirus (“Long Covid”) in an Afro Caribbean Patient: A Case Report

Syncope as a Long Term Effect of Coronavirus (“Long Covid”) in an Afro Caribbean Patient: A Case Report

985-P: Black New Yorkers with Type 2 Diabetes: Afro-Caribbean Immigrants Have Better Cardiometabolic Health than African Americans

Using the 2013/14 New York City Health and Nutrition Examination Survey population sample, this study compared Afro Caribbean immigrants and US-born African American New Yorkers to determine a) whether prevalence and odds of type 2 diabetes (T2DM) differed between ethnic groups; and b) whether cardiometabolic health profiles differed among those with T2DM. T2DM was defined by prior diagnosis, HbA1c≥6.5%, or fasting glucose ≥126mg/dL. Weighted logistic regression estimated odds of T2DM adjusting for BMI, waist circumference, age, sex, education, income, marital status and physical activity. T2DM prevalence in Afro Caribbeans (n=81, age (Mean±SE) 49±2y, BMI 29.2 ±0.7kg/m2) was 31%, and 21% in African Americans (n=118, age 46±2years, BMI 30.3±0.9kg/m2). Afro Caribbeans had more than three times greater odds of T2DM than African Americans [aOR=3.32 (95%CI 1.11-9.88), P=0.0313]. Compared to African Americans with T2DM (n=21, Age 60.3±3.3y, BMI 34.6±1.7kg/m2), Afro Caribbeans with T2DM (n=23, Age 57.9±2.5y, BMI 29.9±0.8kg/m2) were less likely to have obesity (33.2% vs. 74.7%) and had lower waist circumference (102±2cm vs. 114±3cm, P=0.002). Although fewer Afro Caribbeans with T2DM met HP2010 physical activity goals (42.9% vs. 75.5%, P=0.0335), their mean HDL levels tended to be higher than those of African Americans with T2DM (50.6±2.5 mg/dL vs. 42.5±3.2mg/dL, P=0.0519). Afro Caribbean immigrants in New York City have higher odds of T2DM than African Americans. Nevertheless, Afro Caribbeans with T2DM have better cardiometabolic health than African Americans with T2DM. Differences in anthropometrics, blood lipids and health behaviors illustrate important intraethnic variations which affect future risk of T2DM complications among populations of African descent. Disclosure M. Farag: None. L. Khosla: None. S. Bhat: None. F. A. Montiel ishino: None. F. Williams: None. M. F. Horlyck-romanovsky: None.

The effect of stress exposure on depressive symptoms and major depressive episode among US Afro-Caribbean women.

This study examines whether stress exposures experienced within and across various life domains (e.g., interpersonal, financial) are predictors of depression among Afro-Caribbean women, an understudied ethnic group within the US Black female population. A sample of Afro-Caribbean women (N = 878) was drawn from the National Survey of American Life (NSAL), the first nationally representative psychiatric epidemiology survey focused on the mental health of the US Afro-Caribbean and African American populations. Negative binomial regression analysis was conducted for depressive symptoms, and binary logistic regression results are presented for past-year and lifetime major depressive episode. Analyses examined the relative effect of five stress exposures on depression: major discrimination, everyday discrimination, past-month chronic stress, financial strain, and negative interactions with family. Of the five stress exposures, chronic stress and financial strain were associated with increased risk for both recent (e.g., past week) and more distal (i.e., past-year and lifetime) experiences of depression. Though experiences with discrimination were associated with depression, its effects were attenuated when other stressors were taken into account. Mental health prevention and intervention programs must address stress concerns that are chronic in nature and stressors that reflect financial instability for Afro-Caribbean women.

DISTRIBUTION OF SPOT URINARY ELECTROLYTES AND THEIR PREDICTED 24 HOUR LEVELS BY ETHNICITY ASSOCIATIONS WITH MORTALITY IN A LONGITUDNAL COHORT

Objective: Hypertension is a modifiable risk factor for development of cardiovascular disease. Increased urinary sodium excretion, representing high dietary sodium intake is associated with hypertension. Observational cohort studies consistently demonstrate a low sodium intake is also associated with increased mortality. It is not known what the optimal amount of salt intake is good for cardiovascular health. Hypertension is a modifiable risk factor for development of cardiovascular disease. Increased urinary sodium excretion, representing high dietary sodium intake is associated with hypertension. Observational cohort studies consistently demonstrate a low sodium intake is also associated with increased mortality. It is not known what the optimal amount of salt intake is good for cardiovascular health. Design and method: Urine samples were obtained from 331 people [100 Afro-Caribbean (AC), 118 European and 113 Gujarati Indians] to estimate 24-hour sodium and potassium excretion. Association between estimated urinary sodium, potassium and creatinine excretion to composite outcome of major cardiovascular event and death were examined. We also aimed to study if ethnicity influenced this relationship. Results: We noted heterogeneity in association between sodium, potassium, creatinine excretion and mortality. Significantly higher, age-sex adjusted, spot urinary sodium (OR- 2.7; CI – 1.9–3.2) and creatinine (OR- 1.7; CI – 1.2–2.2) levels were seen in AC men who also had higher mean diastolic blood pressure (84 ± 5.5 vs 78 ± 3.3; p &lt; 0.05). Overall, 42.9% (n = 142) of the cohort were hypertensive. Of the 331 eligible participants at baseline, a total 69 cardiovascular deaths were recorded. Spot sodium levels were higher in those who died from cardiovascular causes [(125.3; CI- 116.9, 133.7) mmol/l] vs [(108.7; CI - 99.4 – 118.0); p = 0.02]. Survival was associated with a urinary sodium below and urinary potassium above the median. There was no survival advantage associated with differences in creatinine output. Conclusions: This study estimates a sodium intake of between 2.0 g/day and 2.5 g/day as being associated with a lower risk of death and cardiovascular events. A higher potassium excretion was associated with a lower risk of death and cardiovascular events. Creatinine output made no difference to survival advantage.

The contributions of everyday and major experiences of racial discrimination to current alcohol use and regular smoking in Black adults: Considering variation by demographic characteristics and family history

Background: Racial discrimination has consistently been linked to elevated alcohol use and smoking in Black adults, but the independent contributions of everyday and major experiences of discrimination have rarely been investigated. The present study aimed to identify variation in magnitude of the links between each type of racial discrimination with current frequency of alcohol use and regular smoking by demographic characteristics and family history of problem drinking/regular smoking in Black adults in the U.S. Methods: Data were drawn from 4462 adults (29.40% Afro Caribbean, 70.60% African American; 63.20% female) in a nationally representative sample of Black Americans. Logistic regression analyses were conducted to predict current frequency of alcohol use and regular smoking using the Everyday Discrimination Scale (EDS) and Major Experiences of Discrimination Scale (MEDS), testing for interactions with demographic characteristics and family history. Results: In the alcohol model, an EDS by education level interaction was observed: OR = 1.04 (CI:1.02–1.07) for < high school; OR = 0.95 (CI:0.92–0.98) for ≥ high school. MEDS was independently associated with alcohol use (OR = 1.11, CI:1.04–1.18). In the smoking model, EDS was associated with elevated risk (OR = 1.03, CI:1.01–1.04) and a MEDS by age cohort interaction was observed: OR = 1.24 (CI:1.11–1.38) for <age 45; OR = 1.07 (CI:0.97–1.19) for ages 45–65. Conclusions: Everyday and major experiences of racial discrimination contribute independently to both alcohol use and regular smoking in Black adults, with some variation by education level and age. Differentiating everyday from major experiences of discrimination in studies of mechanisms linking racial discrimination to substance use will enhance their informativeness for intervention development.

Abstract B093: Cervical cancer screening among Blacks: A comparative analysis from the 2010-2014 National Health Interview Surveys

Abstract Background: Pap testing has decreased cervical cancer incidence in the United States. However, persons of African descent are disproportionately burdened and experience worse health outcomes due to underutilization of screening services. Purpose: Identify and compare the prevalence of Pap smear testing among African-American (AA), African immigrant (AI) and Afro-Caribbean (AC) women living in the United States. Methods: A retrospective study was conducted using the 2010-2014 National Health Interview Survey data. Females of African descent, aged of 21-65, categorized into the 3 subgroups were included. We analyzed the prevalence of ever receiving Pap test and performed multivariate logistic regression to compare the likelihood of Pap testing among the 3 groups. Results: Total of 3,740 respondents comprising 3,373 (90%) AA, 163 (4%) AI and 204 (6%) AC. 92% of AA reported Pap testing in the past, compared to 86% AC and 68% AI. After adjusting for age, marital status, insurance, education and income, the odds of Pap testing were 86% lower among AI [OR: 0.14,] and 56% lower among AC women [OR: 0.44] than AA. Conclusion: This study highlights importance of addressing cancer screening needs of each subgroup separately. Studies on the impact of culture on the subgroups' screening behaviors are needed. Note: This abstract was not presented at the conference. Citation Format: Joycelyn Cudjoe. Cervical cancer screening among Blacks: A comparative analysis from the 2010-2014 National Health Interview Surveys [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B093.

Profiles of Psychosocial Risk and Protective Factors and their Associations with Alcohol Use and Regular Smoking in Black Adults.

This study aimed to identify the clustering of substance use-related psychosocial risk and protective factors (subgroups) and the differential associations of those subgroups with current alcohol use and regular smoking among Black adults. Data were drawn from 4462 participants (29% Afro Caribbean, 71% African American; median age = 38; 63% female) in a nationally representative study of social, economic, and structural conditions and health in Black Americans. Latent classes, i.e., subgroups, were derived via latent profile analysis with 10 indicators representing social support and religious involvement (support); demands from family and religious community (demands); and socioeconomic and neighborhood factors and racial discrimination (adversity). Frequency of alcohol use and prevalence of regular smoking were compared across classes using regression analyses. Four classes emerged: (1) high support, low demands and adversity; (2) high support and demands, low-moderate adversity; (3) low support and demands, low-moderate adversity; and (4) low support, high demands and adversity. Relative to Class 1, frequency of alcohol use and regular smoking prevalence were significantly higher only in Class 4. Results indicate substantive variations in the clustering of substance use-related psychosocial risk and protective factors in Black adults. Furthermore, they suggest that neither the presence of high demands nor the absence of support alone differentiates likelihood of engaging in frequent alcohol use or regular smoking, but adverse experiences such as racial discrimination may be especially impactful.

Abstract P473: Social Determinants of Cardiovascular Health Among Afro-Caribbean Immigrants in New York City

Introduction: Research on cardiovascular health (CVH) and risk factors among immigrants has been well-documented. Less is known about social influences on CVH, among black immigrants. Despite having the largest population of black immigrants in the U.S., Afro-Caribbean (AC) immigrants have been underrepresented in health research. We examined the social determinants of CVH among AC immigrants (Guyanese, Haitian and Jamaican) in New York City (NYC). Hypothesis: We hypothesized that social determinants of CVH will vary among the three ethnic sub-groups of AC immigrants. Methods: We included 1691 AC immigrants who reported their race as non-Hispanic Black and country of birth (COB) as Guyana (n= 369), Haiti (n= 291) or Jamaica (n= 1031) in the 2010-2014 administrations of the New York City Community Health Survey. Logistic regression analysis was performed to assess the association between social determinants and CVH (ideal vs intermediate/poor) using AHA’s CVH metrics. Results: The majority of the sample was female (59.2%) and reported high school education or less (53.9%). Most AC immigrants reported to have ideal CVH (71.3%). Education was significantly associated with CVH only among Jamaican immigrants. Jamaican immigrants with ≤ high school education were more likely to have intermediate/poor CVH compared to those with ≥ some college education. Conclusions: These findings suggest that social determinants influencing CVH differ among AC immigrant sub-groups in NYC. These findings suggest that social determinants influencing CVH differ among AC immigrant sub-groups in NYC. National surveillance efforts should obtain more complete data on country of origin and oversample racial/ethnic minority groups in order to better understand their CVH outcomes. Future research should examine other social factors that may influence CVH among black immigrants.

Triglycerides as a Metabolic Target in Afrocaribbean Infertile Women with Polycystic Ovary Syndrome.

Background: Polycystic ovary syndrome (PCOS) is classically associated with insulin resistance, metabolic syndrome, or type 2 diabetes. Infertile Afrocaribbean (AC) women with PCOS may have metabolic features that could help to better target their management. Objective: To evaluate the characteristics of PCOS in this population and their metabolic profile to target the worst metabolic parameter. Methods: A retrospective study including infertile AC women for 4 years. PCOS was diagnosed using Rotterdam criteria and compared with non-PCOS women referred consecutively for infertility during the same period. Results: Among 981 AC women evaluated for infertility, PCOS was found in 17%. PCOS women were younger than non-PCOS women. After age and body mass index (BMI) matching, only fasting blood glucose and triglyceride levels were higher in PCOS women compared with non-PCOS women. PCOS was positively correlated with triglyceride levels and negatively with vitamin D levels. PCOS women with obesity had low high-density lipoprotein-cholesterol and increased triglyceride levels compared with those without obesity. No correlation was found between lipids or glucose levels and androgen levels. Multivariate analysis showed that only triglycerides were independently related to PCOS after adjustment for age and BMI. Conclusions: In the AC population where the prevalence of obesity and diabetes is increased, the metabolic profile of infertile women with PCOS is mainly characterized by hypertriglyceridemia, with a higher risk of visceral obesity and nonalcoholic fatty liver disease. Interventional studies would be useful to evaluate the predictive value of hypertriglyceridemia on diabetes and cardiovascular diseases in this population.

P3839Hypertension or hypertrophic cardiomyopathy? Using cardiovascular magnetic resonance imaging to unmask the great imitator

Abstract Background Structural cardiac adaptations due to hypertension (HTN) present a diagnostic challenge when differentiating from hypertrophic cardiomyopathy (HCM), using traditional imaging techniques such as echocardiography (echo). Cardiac magnetic resonance imaging (CMR) offers reproducible anatomical, functional quantification and myocardial tissue characterisation which discriminates between hypertension and HCM. Purpose To identify hypertensive individuals with undiagnosed HCM using CMR imaging. Methods 100 consecutive hypertensive patients underwent CMR at a tertiary centre dedicated blood pressure clinic (55% male, mean age 51 years). In keeping with ESC guidelines, end diastolic wall thickness (EDWT) ≥15mm identified individuals within the “grey zone” between hypertension and with a potential HCM diagnosis. 19 individuals were referred on to the dedicated inherited cardiac conditions clinic for further evaluation. Four patients expressed a definitive LV phenotype and were diagnosed with HCM. CMR parameters were compared in three groups: Hypertensive (HTN), “grey zone” Hypertensive (GZH) and HCM. Results CMR demonstrated end diastolic wall thickness (EDWT) &gt;11 mm in 50% of hypertensives. 73% of the referred patients were Afro-Caribbean (AC) and all 4 HCM patients were AC. All referrals demonstrated EDWTs ≥14mm, 9 (47%) demonstrated late gadolinium enhancement of which 3 (16%) had HCM. Three had asymmetrical septal hypertrophy – 2 were in the HCM cohort and one underwent endomyocardial biopsy confirming HTN. Left ventricular mass index (LVMI) was significantly higher in GZH compared to HTN (p&lt;0.0001) and in HCM compared to HTN (p=0.0004). EDWT was significantly greater in GZH compared to HTN (p&lt;0.0001) and in HCM compared to HTN (p=0.0002). There was no significant difference in these parameters between GZH and HCM. Table 1. P-values for CMR data in hypertensive (HTN), gray zone hypertensive (GZH) and hypertrophic cardiomyopathy (HCM) cohorts CMR Parameter HCM vs. HTN GZH vs. HTN GZH vs. HCM EDVI NS p=0.025 NS EDWT p=0.0002 p&lt;0.0001 NS LVMI p=0.0004 p&lt;0.0001 NS Conclusion This study reports a 4% prevalence of HCM among hypertensive patients - 20 x greater than in the general population - which would be left undiagnosed using echo alone. Screening hypertensive individuals with CMR is not routine but we advocate its use in these individuals especially in Afro Caribbeans and in those in the “grey zone”, to identify undiagnosed HCM, which has significant implications for lifestyle modification and family screening. Acknowledgement/Funding Cardiac Risk in the Young

Abstract 3343: The Florida women’s cancer study: Breast cancer presentation among African American and Afro Caribbean women in south Florida, a 10-year cohort

Abstract Introduction: The Black population in the US constitutes about 4 million immigrants. Of this, 50% is from the Caribbean region. Jamaica is the largest contributing country, followed by Haiti and Trinidad and Tobago. Florida has the second largest Caribbean population in the USA. Breast cancer is the main cause of cancer death among females responsible for 14%-30% of cancer deaths in the Caribbean; this is up to two times higher than the USA. Little is known about the molecular subtypes of breast cancer and the demographics of Black Caribbean Immigrants. Objectives: Study the demographics of BC patients in the African diaspora, determine similarities and differences in cause, subtype and outcome of women with breast cancers in African American (AA) and Afro-Caribbean (AC) immigrants. Methods: Approved by the Ethics Committee of the University of Miami IRB. Patients treated for breast cancer between 2006 to 2016 were included. Abstracted data included sociodemographic factors, genetic testing results, and treatment histories. Results: A retrospective US-based cohort of 1369 women (self-identified as black), diagnosed with BC - the Florida Women’s Cancer Study (FLWCS), at Sylvester Comprehensive Cancer Center and Jackson Memorial Hospital in Florida. This cohort contains data from 624 (46%) African-American (AA) women and 507 (37%) AC women diagnosed with breast cancer between 2006-2016. Ninety per cent (n=1232) of the cohort is of non-Hispanic ethnicity.FLWCS country distribution includes is composed of Haiti (18.3%), Jamaica (6.5%), Bahamas (3.1%), Cuba and Dominica Republic (2.8% each), Trinidad and Tobago (1%) and other nationalities from the Organization of Eastern Caribbean States (Antigua, St. Kitts and Nevis, Anguilla, Dominica, St. Lucia and Grenada) at 2.5%. ACwomen living in Miami were diagnosed at a younger age (53.7 years versus 54.9 years), than AA women.Twenty-eight percent of the AA women were premenopausal compared with 32% of the AC women. The AA women had a higher BMI, 32.1 vs 29.8 (p=0.0001), a lower proportion of HER2 positive breast cancer of 17.6% versus 23% (p=0.027), and more children 3.1 versus 2.8 (p=0.023), than the AC women. The rate of HER2 overexpression in the Caucasian population is12% while HER2 positivity was seen in 26.2% Jamaican women, 25.8% in Haitian women and 26.5% in Cuban women (p=0.043) respectively. Less than 5% of the cohort underwent genetic testing with less than 1% having a pathogenic germline mutation. Conclusion: African American (AA) and AC women have many similarities there are significant differences in terms of ancestral diversity, inherited genetic mutations, environmental exposures and access to medical care. Thus, it is imperative to gain an understanding of the causes of cancer in AC women in their own countries in order to better serve those immigrant populations once they reach the US. Citation Format: Priscila Barreto Coelho, Matthew Schlumbrecht, Danielle Cerbon, Carlos Parra, Judith Hurley, Sophia George. The Florida women’s cancer study: Breast cancer presentation among African American and Afro Caribbean women in south Florida, a 10-year cohort [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3343.

Abstract P126: The Cardiovascular Health of Afro-Caribbean Immigrants in New York City: a Cross Sectional Study

Introduction: Afro-Caribbean (AC) immigrants are the largest black immigrant group in the U.S. and generally display better physical health than United States (U.S.) born blacks. Cardiovascular health (CVH) disparities among AC immigrant sub-groups are poorly understood. We examined the prevalence of CVH factors among AC immigrants (Guyanese, Haitian and Jamaican) relative to U.S. born blacks residing in New York City. We hypothesized that some AC immigrant sub-groups will have higher rates of CVH factors than U.S. born blacks. Methods: We performed a cross-sectional analysis of pooled data from the 2010-2014 New York City Community Health Survey administrations to estimate the prevalence of CVH and differences among AC immigrant sub-groups. We included 7678 non-Hispanic black participants from Haiti (n=291), Jamaica (n=1031), Guyana (n=369) and U.S. born blacks (5987). Logistic regression was used to examine the association between country of birth and CVH factors. The CVH factors were determined from the AHA’s CVH metrics. We adjusted the models for significant covariates using backward sequential selection. Results: In final adjusted models, in comparison to U.S. born blacks, Jamaican immigrants were more likely to self-report diabetes but were less likely to be overweight/obese. Guyanese immigrants were also less likely to be overweight/obese than U.S. born blacks. There were no significant differences between Haitian immigrants and U.S. born blacks for CVH factors. Conclusions: Although AC immigrants depict superior health status compared to U.S. born blacks, ethnic differences exist in CVH among AC immigrant sub-groups. Efforts to address cardiovascular health factors among black populations in the U.S. should consider ethnic differences that may provide information about the most at-risk populations for disease-specific programmatic or policy interventions.

Abstract MP20: Ethnic Differences in Coronary Heart Disease and Stroke Diagnosis Among Blacks in the United States

Introduction: African-Americans bear a disproportionate burden of atherosclerotic cardiovascular disease than other racial/ethnic groups in the U.S. With current globalization trends, Black immigrants from Africa and Caribbean Islands contribute to the ethnic diversity of Blacks in the U.S. Despite the diversity in socioeconomic status, culture and genetic admixture, Black immigrants are traditionally combined with African Americans, therefore limiting opportunities to understand the health of Black immigrants. Hypothesis: Ethnic differences in coronary heart disease (CHD) and stroke prevalence exist among African-Americans (AAs), African-immigrants (AIs) and Afro-Caribbean (ACs). Methods: We conducted a cross-sectional study of the 2010-2016 National Health Interview Survey. CHD and stroke diagnoses were self-reported. We performed a descriptive and multivariable logistic regression analyses adjusting for demographic and health characteristics and stratified by sex. Results: We included 34,513 participants who were AAs (N=30,516), AIs (N=1,371) and ACs (N=2,626). Significant differences in sociodemographic characteristics were observed. AIs were the youngest (39 years) with the highest proportion of college graduates (51%). AAs (42%) were more likely to report hypertension diagnosis than AIs (19%) and ACs (36%) (p&lt;0.05)Also, AAs (44%) were more likely to be overweight/obese than AIs (24%) and ACs (31%) (p&lt;0.05). Diabetes prevalence was similar for AAs (13.7%) and ACs (12.8%), and lower for AIs (6.3%). Adjusted models showed that AAs were more likely to report CHD or stroke diagnoses than AIs and ACs (p&lt;0.05). Sex-stratified models showed AA (4.2%) and AI (3.2%) women reporting similar rates of CHD diagnosis. (Table) Conclusion: Ethnic differences were noted in the prevalence of CHD and stroke diagnosis and risk among Blacks. Future studies should examine the health advantage of AIs and ACs to inform interventions and policy to improve the health of AAs and maintain the health of foreign-born Blacks.

Length of Residence and Cardiovascular Health among Afro-Caribbean Immigrants in New York City.

Cardiovascular disease (CVD) disproportionately affects non-Hispanic blacks (NHB) in the United States (U.S.). Afro-Caribbean (AC) immigrants comprise over 50% of the immigrant black population and are critical in understanding the health trajectories of blacks in the U.S. We assessed the relationship between length of residence (proxy measure for acculturation) and cardiovascular health (CVH) based on the American Heart Association's (AHA) seven ideal cardiovascular health components among AC immigrants in New York City (NYC). CVH scores were categorized into poor/intermediate CVH (0-3 components) or ideal CVH (≥ 4 components). Multivariable logistic regression was used to examine the association between length of residence in the U.S. and poor/intermediate CVH. In adjusted models, the odds of poor/intermediate CVH were significantly higher for Guyanese (OR = 3.51; 95% CI 1.03-11.95) and Haitian immigrants (OR = 8.02; 95% CI 1.88-34.12) residing in the U.S. for ≥ 10years than for those living in the U.S. for < 10years. Length of residence was not significantly associated with CVH among Jamaican immigrants. We found evidence of ethnic differences in the association between acculturation and CVH among AC immigrants in a major metropolitan city. Culturally tailored interventions are needed to improve the CVH of AC immigrants as they become integrated into the U.S., with special consideration of country of birth.