Lê-Scherban Félice, Albrecht Sandra S, Bertoni Alain, Kandula Namratha, Mehta Neil, Diez Roux Ana V
Department of Epidemiology and Biostatistics, Dornsife School of Public Health, Drexel University, Philadelphia, PA.
Department of Nutrition, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill.
Ann Epidemiol. 2016 Jun;26(6):429-435.e1. doi: 10.1016/j.annepidem.2016.04.008. Epub 2016 Apr 27.
Despite cross-sectional evidence that foreign-born United States (US) residents often have better health than US-born residents of similar race and/or ethnicity, we know little about overall cardiovascular risk progression over time among immigrants as they age in the US.
Using longitudinal data from the Multiethnic Study of Atherosclerosis on 6446 adults aged 45-84 years at baseline, we examined how nativity and length of US residence related to change in cardiovascular health (CVH) and cardiovascular event incidence over 11-year follow-up. CVH was measured using the American Heart Association's CVH measure (range, 0-14; higher is better).
Immigrants, particularly those with shorter US residence, had better baseline CVH and lower cardiovascular event incidence than the US born. Baseline CVH scores ranged from 8.67 (8.42-8.92) among immigrants living in the US less than 10 years to 7.86 (7.76-7.97) among the US born. However, recent immigrants experienced the largest CVH declines over time: 10-year declines ranged from -1.04 (-1.27 to -0.80) among immigrants living in the US less than 10 years at baseline to -0.47 (-0.52 to -0.42) among the US born.
Public health prevention efforts targeting new immigrants may help slow the deterioration of CVH and reduce future cardiovascular risk.
尽管有横断面证据表明,在美国出生的外国居民往往比同种族和/或民族的美国本土居民健康状况更好,但对于移民在美国随着年龄增长其心血管疾病总体风险的长期变化情况,我们了解甚少。
利用动脉粥样硬化多民族研究中6446名基线年龄在45 - 84岁的成年人的纵向数据,我们研究了出生国家和在美国居住的时长与11年随访期间心血管健康(CVH)变化及心血管事件发生率之间的关系。CVH采用美国心脏协会的CVH测量方法进行评估(范围为0 - 14;分数越高越好)。
移民,尤其是在美国居住时间较短的移民,其基线CVH状况更好,心血管事件发生率低于美国本土出生的人。基线CVH分数范围从在美国居住不到10年的移民中的8.67(8.42 - 8.92)到美国本土出生者中的7.86(7.76 - 7.97)。然而,随着时间推移,新移民的CVH下降幅度最大:10年下降幅度从基线时在美国居住不到10年的移民中的-1.04(-1.27至-0.80)到美国本土出生者中的-0.47(-0.52至-0.42)。
针对新移民的公共卫生预防措施可能有助于减缓CVH的恶化,并降低未来心血管疾病风险。