title: Sex Differences in Cardiovascular Disease Risk of Ghanaian- and Nigerian-Born West African Immigrants in the United States: The Afro-Cardiac Study.
abstract: BACKGROUND
  The number of African immigrants in the United States grew 40-fold between 1960 and 2007, from 35 355 to 1.4 million, with a large majority from West Africa. This study sought to examine the prevalence of cardiovascular disease (CVD) risk factors and global CVD risk and to identify independent predictors of increased CVD risk among West African immigrants in the United States.
  
  
  RESULTS
  This cross-sectional study assessed West African (Ghanaian and Nigerian) immigrants aged 35-74 years in the Baltimore-Washington metropolitan area. The mean age of participants was 49.5±9.2 years, and 58% were female. The majority (95%) had ≥1 of the 6 CVD risk factors. Smoking was least prevalent, and overweight or obesity was most prevalent, with 88% having a body mass index (in kg/m(2)) ≥25; 16% had a prior diagnosis of diabetes or had fasting blood glucose levels ≥126 mg/dL. In addition, 44% were physically inactive. Among women, employment and health insurance were associated with odds of 0.09 (95% CI 0.033-0.29) and 0.25 (95% CI 0.09-0.67), respectively, of having a Pooled Cohort Equations estimate ≥7.5% in the multivariable logistic regression analysis. Among men, higher social support was associated with 0.90 (95% CI 0.83-0.98) lower odds of having ≥3 CVD risk factors but not with having a Pooled Cohort Equations estimate ≥7.5%.
  
  
  CONCLUSIONS
  The prevalence of CVD risk factors among West African immigrants was particularly high. Being employed and having health insurance were associated with lower CVD risk in women, but only higher social support was associated with lower CVD risk in men.
authors.affiliation: Emory University, Nell Hodgson Woodruff School of Nursing, Atlanta, GA ycommod@emory.edu.
authors.forename: Yvonne
authors.initials: Y
authors.lastname: Commodore-Mensah
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD.
authors.forename: Martha
authors.initials: M
authors.lastname: Hill
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD.
authors.forename: Jerilyn
authors.initials: J
authors.lastname: Allen
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Cooper
authors.affiliation: Johns Hopkins School of Medicine, Baltimore, MD.
authors.forename: Roger
authors.initials: R
authors.lastname: Blumenthal
authors.affiliation: Department of Public Health, Academic Medical Centre/University of Amsterdam, The Netherlands.
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
authors.affiliation: Johns Hopkins University School of Nursing, Baltimore, MD.
authors.forename: Cheryl Dennison
authors.initials: CD
authors.lastname: Himmelfarb
mesh_terms: D000328:Adult; D000368:Aged; D044383:Black People; D001786:Blood Glucose / Q000032:analysis; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000517:prevention & control; D016009:Chi-Square Distribution; D015897:Comorbidity; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000175:diagnosis / Q000208:ethnology; D054242:Emigrants and Immigrants; D004641:Emigration and Immigration; D004651:Employment; D005260:Female; D005869:Ghana / Q000208:ethnology; D006304:Health Status; D006801:Humans; D007348:Insurance, Health; D008019:Life Style / Q000208:ethnology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009549:Nigeria / Q000208:ethnology; D009765:Obesity / Q000175:diagnosis / Q000208:ethnology; D016017:Odds Ratio; D015995:Prevalence; D065840:Protective Factors; D018570:Risk Assessment; D012307:Risk Factors; D057185:Sedentary Behavior / Q000208:ethnology; D012907:Smoking / Q000009:adverse effects / Q000208:ethnology; D012944:Social Support; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D001741:Black or African American
chemical_list: D001786:Blood Glucose
keywords: African immigrants; cardiovascular disease; migrant health