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. 2008 Nov;98(11):1963-70.
doi: 10.2105/AJPH.2007.123844. Epub 2008 May 29.

Associations of acculturation and socioeconomic status with subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis

Pamela L Lutsey  1 , Ana V Diez Roux, David R Jacobs Jr, Gregory L Burke, Jane Harman, Steven Shea, Aaron R Folsom
Affiliations

Associations of acculturation and socioeconomic status with subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis

Pamela L Lutsey et al. Am J Public Health. 2008 Nov.

Abstract

Objectives: We assessed whether markers of acculturation (birthplace and number of US generations) and socioeconomic status (SES) are associated with markers of subclinical cardiovascular disease-carotid artery plaque, internal carotid intima-media thickness, and albuminuria-in 4 racial/ethnic groups.

Methods: With data from the Multi-Ethnic Study of Atherosclerosis (n = 6716 participants aged 45-84 years) and race-specific binomial regression models, we computed prevalence ratios adjusted for demographics and traditional cardiovascular risk factors.

Results: The adjusted US- to foreign-born prevalence ratio for carotid plaque was 1.20 (99% confidence interval [CI] = 0.97, 1.39) among Whites, 1.91 (99% CI = 0.94, 2.94) among Chinese, 1.62 (99% CI = 1.28, 2.06) among Blacks, and 1.23 (99% CI = 1.15, 1.31) among Hispanics. Greater carotid plaque prevalence was found among Whites, Blacks, and Hispanics with a greater number of generations with US residence (P < .001) and among Whites with less education and among Blacks with lower incomes. Similar associations were observed with intima-media thickness. There was also evidence of an inverse association between albuminuria and SES among Whites and Hispanics.

Conclusions: Greater US acculturation and lower SES were associated with a higher prevalence of carotid plaque and greater intima-media thickness but not with albuminuria. Maintenance of healthful habits among recent immigrants should be encouraged.

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Figures

FIGURE 1
FIGURE 1
Prevalence of carotid plaque stratified by race/ethnicity and adjusted for age, gender, education, and income, by place of birth (a) and generation of US residence (b): Multi-Ethnic Study of Atherosclerosis, 2000–2002.
See this image and copyright information in PMC

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