Differing cardiovascular risk profiles of black subgroups in the u.s

Background. Cardiovascular disease (CVD) poses a significant health challenge for the U.S. born black population; however, little research has examined the CVD risk profiles of black immigrants. Black immigrants are a rapidly growing population, yet are oftentimes aggregated in analyses with U.S. born blacks. Disentangling the health of black immigrants can have important implications for understanding their disease and mortality patterns as this group becomes a larger share of the black population. Methods. This cross sectional study employed data from the 2008-2009 National Health and Nutrition Examination Study (NHANES) to examine clinical measures of CVD and CVD risk factors such as physical activity and diet among U.S. born (n=2,124) and foreign born (n=87) black adults. Results. Heterogeneity in CVD risk profiles was observed. US born blacks had smaller waist circumferences (86.0cm versus 91.5cm p<.05) and lower systolic blood pressure (121.8 mm/Hg versus 128.0 mm/Hg p<.05) compared to foreign born blacks. However, U.S. born blacks experienced higher levels of glycohemoglobin (p<.001) and C-reactive protein (p<.05). Foreign born blacks reported lower smoking behavior (15% versus 25%, p<.05) yet engaged in less physical activity compared to U.S. born blacks (3.4 days per week versus 3.0 p<.05). Conclusion. These finding suggest that the healthy immigrant effect where immigrants exhibit better health than U.S. born individual, may not fully operate for black immigrants in regards to CVD. Thus, future development of health and policy interventions need to account for differences among black subgroups and their vulnerability in experiencing CVD risk factors.