Association between language and risk factor levels among Hispanic adults with hypertension, hypercholesterolemia, or diabetes

• Published in: The American heart journal 2009, Vol.157 (1), p.53-59
• Main Authors: Eamranond, Pracha P., MD, MPH, Legedza, Anna T.R., ScD, Diez-Roux, Ana V., MD, PhD, Kandula, Namratha R., MD, MPH, Palmas, Walter, MD, MS, Siscovick, David S., MD, MPH, Mukamal, Kenneth J., MD, MPH
• Format: Article
• Language: English
• Subjects: Acculturation; Arterial hypertension. Arterial hypotension; Biological and medical sciences; Blood and lymphatic vessels; Cardiology. Vascular system; Cardiovascular; Cardiovascular disease; Cholesterol; Communication Barriers; Diabetes Mellitus - epidemiology; Diabetes. Impaired glucose tolerance; Disorders of blood lipids. Hyperlipoproteinemia; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Etiopathogenesis. Screening. Investigations. Target tissue resistance; Female; Health risk assessment; Hispanic Americans - ethnology; Humans; Hypercholesterolemia - epidemiology; Hypertension - epidemiology; Language; Low density lipoprotein; Male; Medical sciences; Metabolic diseases; Middle Aged; Risk Factors
• ISSN: 0002-8703; 1097-6744
• DOI: 10.1016/j.ahj.2008.08.015

Background The association of acculturation and cardiovascular risk factor control among populations with high proportions of immigrants has not been well studied. Methods We studied 1,492 Hispanic participants in the Multi-Ethnic Study of Atherosclerosis (MESA) with hypertension, hypercholesterolemia, and/or diabetes. We used linear regression to examine the cross-sectional relationships between acculturation measures and cardiovascular risk factor levels. Outcome measures included systolic blood pressure (mm Hg), fasting low-density lipoprotein (LDL) cholesterol (mg/dL), and fasting blood glucose (mg/dL). Covariates included education, income, health insurance, physical activity, dietary factors, risk factor–specific medication use, duration of medication use, smoking, and body mass index. Results There were 580 Hispanics with hypertension, 539 with hypercholesterolemia, and 248 with diabetes. After adjustment for age and gender, Spanish-speaking Hispanics with cardiovascular risk factors had higher systolic blood pressure, fasting LDL cholesterol, and fasting blood glucose compared to English-speaking Hispanics. Differences in systolic blood pressure were accounted for mainly by education, whereas differences in LDL cholesterol were almost entirely accounted for by cholesterol-lowering medication use. Differences in fasting glucose were partly accounted for by socioeconomic variables but were augmented after adjustment for dietary factors. Similar associations were observed between proportion of life in the United States and risk factor levels. Conclusions Among those with cardiovascular risk factors, Hispanics who spoke Spanish at home and lived less time in the United States had worse control of cardiovascular risk factors. Treatment strategies that focus on Hispanics with low levels of acculturation may improve cardiovascular risk factor control.