Article Text
Abstract
Objective Hispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function.
Design Cross-sectional.
Setting The Echocardiographic Study of Latinos.
Participants 1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language.
Primary and secondary outcome measures Echocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities.
Results The study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m2. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e′ but lower LAVI and e′ velocities compared with the second generation. Higher acculturation and income >$20K were associated with higher LVMI, LAVI and E/e′ but lower e′ velocities. Preferential Spanish-speakers with an income <$20K had a higher E/e′.
Conclusions Acculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status.
- acculturation
- echocardiogram
- hispanics/latinos
- socioeconomic status
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Footnotes
Contributors Research conception and design: CJR and LL; collection and assembly of data: CJR, MA, RCK and LG; analysis and interpretation of the data: CJR, LL and KS; drafting of the article: CJR, LL and FR; critical revision of the article for important intellectual content: CJR, LL, FR, JRK, FP, LG, WA and FG; obtaining of funding: CJR, RCK and MA; statistical expertise: KS, FG; CJR and LL are responsible for the overall content as guarantors.
Funding This study supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234), Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236) and San Diego State University (N01-HC65237). The following institutes contributed to Hispanic Community Health Study/Study of Latinos (HCHS/SOL): National Institute on Minority Health and Health Disparities, National Institute on Deafness and Other Communication Disorders, National Institute of Dental and Craniofacial Research, National Institute of Diabetes and Digestive and Kidney Diseases, National Institute of Neurological Disorders and Stroke and NIH Institution-Office of Dietary Supplements. ECHO-SOL was supported by the NHLBI (R01 HL104199, Epidemiologic Determinants of Cardiac Structure and Function among Hispanics: CJR, Principal Investigator). LL acknowledges the support of the Robert Wood Johnson Foundation Harold Amos Medical Faculty Development Program and NIDDK 1K23DK098280-01. FR was supported from a career development award from the NHLBI (1K01 HL144607). No relationships with industry supported this work.
Competing interests None declared.
Patient consent for publication Not required.
Ethics approval The Institutional Review Board at the Wake Forest School of Medicine and at each study site(Albert Einstein College of Medicine, Bronx, New York; Northwestern University, Chicago, Illinois; University of Miami, Miami, Florida; University of California, San Diego, San Diego, California; Wake Forest School of Medicine, Winston-Salem, North Carolina) provided approval and oversight of all study materials and activities.
Provenance and peer review Not commissioned; externally peer reviewed.
Data availability statement Data are available on reasonable request.