Key result
US immigrants had higher overall cardiovascular health scores compared to non-immigrants, though they had lower scores for physical activity, glucose, and cholesterol.
Why the study?
Immigrants endure social and structural factors that adversely influence cardiovascular health, prompting an evaluation of overall and individual CVH metrics compared to non-immigrants and across immigrant sub-populations.
Does immigrant status affect cardiovascular health scores in US adults?
Cross-Sectional (n=13,471)
Does immigrant status affect cardiovascular health scores in US adults?
US immigrants have more favorable overall cardiovascular health compared to US-born persons, though specific areas like glycemic control and physical activity require targeted interventions.
Answers are grounded in this paper and cite their sources.
Immigrant CVH patterns may warrant subgroup-specific screening; leaves open causal factors and intervention trials in heterogeneous populations.
Background: The United States (US) has the largest immigrant population globally. Immigrants endure social and structural factors that adversely influence cardiovascular health (CVH), a construct focused on health preservation, not merely the absence of disease, and defined by eight modifiable health factors and behaviors that support healthy longevity. We compared overall and individual CVH metrics between immigrants and non-immigrants and characterized CVH and its determinants among immigrant sub-populations. Methods: The analytic sample included 13,471 adults (19% immigrants, i.e., foreign-born, 51% female), ages 20-79 y (mean ± SD for immigrants and non-immigrants: 44.8 ± 4.8 y and 45.7 ± 11.2 y, respectively) from the 2013 to 2018 National Health and Nutrition Examination Survey. CVH was characterized consistent with the American Heart Association's (AHA) Life's Essential 8 (LE8) guidelines (metrics: body mass index (BMI), blood glucose, blood lipids, blood pressure, nicotine use, sleep health, diet quality, and physical activity; score range: 0-100, low CVH: LE8 score <50). CVH scores were compared among immigrants and non-immigrants and by sex, ethnicity, years in the US, and citizenship among immigrants. Survey-weighted regression models evaluated psychosocial and demographic factors in relation to CVH. Findings: Immigrants had higher overall CVH scores (69.1 vs. 66.4) (p < 0.0001) and significantly higher subscores for diet (52.5 vs. 38.8), nicotine exposure (80.3 vs. 68.0), BMI (61.6 vs. 57.1), and blood pressure (74.1 vs. 71.8), but lower physical activity (47.0 vs. 52.6), glucose (82.2 vs. 86.1), and cholesterol (63.0 vs. 68.5) scores compared to non-immigrants. Among immigrants, those who were male vs. female (67.5 vs. 70.7) (p = 0.003), Hispanic vs. non-Hispanic (66.6 vs. 71.5) (p < 0.0001), and living in the US ≥15 y vs. <15 y (67.7 vs. 71.8) (p < 0.0001) had lower CVH. In regression models, being male, 45+ y, or Hispanic, having food insecurity, lower education and income, depression, no health insurance, and ≥15 y living in the US were associated with lower CVH. Interpretation: While US immigrants have more favorable overall CVH compared to US-born persons, CVH status is complex and heterogenous across immigrant sub-populations. Glycemic control, physical inactivity, and blood lipids may be important targets for CVH promotion interventions in this population; Hispanic immigrants and those who lived in the US for ≥15 y may represent key subpopulations to engage in these efforts.
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Makarem et al. (2025) conducted a cross-sectional in Cardiovascular health (n=13,471). Immigrant status vs. Non-immigrants was evaluated on Overall cardiovascular health (CVH) score (p=<0.0001). US immigrants had higher overall cardiovascular health scores compared to non-immigrants, though they had lower scores for physical activity, glucose, and cholesterol.
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