title: Acculturation is associated with left ventricular mass in a multiethnic sample: the Multi-Ethnic Study of Atherosclerosis.
abstract: BACKGROUND
  Acculturation involves stress-related processes and health behavioral changes, which may have an effect on left ventricular (LV) mass, a risk factor for cardiovascular disease (CVD). We examined the relationship between acculturation and LV mass in a multiethnic cohort of White, African-American, Hispanic and Chinese subjects.
  
  
  METHODS
  Cardiac magnetic resonance assessment was available for 5004 men and women, free of clinical CVD at baseline. Left ventricular mass index was evaluated as LV mass indexed by body surface area. Acculturation was characterized based on language spoken at home, place of birth and length of stay in the United States (U.S.), and a summary acculturation score ranging from 0 = least acculturated to 5 = most acculturated. Mean LV mass index adjusted for traditional CVD risk factors was compared across acculturation levels.
  
  
  RESULTS
  Unadjusted mean LV mass index was 78.0 ± 16.3 g/m(2). In adjusted analyses, speaking exclusively English at home compared to non-English language was associated with higher LV mass index (81.3 ± 0.4 g/m(2) vs 79.9 ± 0.5 g/m(2), p = 0.02). Among foreign-born participants, having lived in the U.S. for ≥ 20 years compared to < 10 years was associated with greater LV mass index (81.6 ± 0.7 g/m(2) vs 79.5 ± 1.1 g/m(2), p = 0.02). Compared to those with the lowest acculturation score, those with the highest score had greater LV mass index (78.9 ± 1.1 g/m(2) vs 81.1 ± 0.4 g/m(2), p = 0.002). There was heterogeneity in which measure of acculturation was associated with LV mass index across ethnic groups.
  
  
  CONCLUSIONS
  Greater acculturation is associated with increased LV mass index in this multiethnic cohort. Acculturation may involve stress-related processes as well as behavioral changes with a negative effect on cardiovascular health.
authors.affiliation: Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA. veffoe@wakehealth.edu.
authors.forename: Valery S
authors.initials: VS
authors.lastname: Effoe
authors.affiliation: Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA. hchen@wakehealth.edu.
authors.forename: Haiying
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Medicine, Columbia University College of Physicians & Surgeons, New York, NY, USA. aem35@cumc.columbia.edu.
authors.forename: Andrew
authors.initials: A
authors.lastname: Moran
authors.affiliation: Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA. abertoni@wakehealth.edu.
authors.forename: Alain G
authors.initials: AG
authors.lastname: Bertoni
authors.affiliation: National Institutes of Health/Clinical Center, Bethesda, MD, USA. bluemked@cc.nih.gov.
authors.forename: David A
authors.initials: DA
authors.lastname: Bluemke
authors.affiliation: Division of Geriatrics, University of California at Los Angeles, Los Angeles, CA, USA. tseeman@mednet.ucla.edu.
authors.forename: Teresa
authors.initials: T
authors.lastname: Seeman
authors.affiliation: University of California at Los Angeles Research Center, Los Angeles, CA, USA. christine.darwin19@gmail.com.
authors.forename: Christine
authors.initials: C
authors.lastname: Darwin
authors.affiliation: Division of Cardiology, University of California at Los Angeles School of Medicine, Los Angeles, CA, USA. kwatson@mednet.ucla.edu.
authors.forename: Karol E
authors.initials: KE
authors.lastname: Watson
authors.affiliation: Division of Public Health Sciences, Wake Forest School of Medicine, Medical Center Blvd, Winston Salem, NC, 27127, USA. crodrigu@wakehealth.edu.
authors.forename: Carlos J
authors.initials: CJ
authors.lastname: Rodriguez
mesh_terms: D000069:Acculturation; D001741:Black or African American / Q000523:psychology; D000368:Aged; D001213:Asian / Q000523:psychology; D050197:Atherosclerosis / Q000208:ethnology* / Q000473:pathology / Q000523:psychology; D005260:Female; D006630:Hispanic or Latino / Q000523:psychology; D006801:Humans; D017379:Hypertrophy, Left Ventricular / Q000208:ethnology*; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D013315:Stress, Psychological; D044465:White People / Q000523:psychology