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J Gen Intern Med. 2007 Jun;22(6):841-6. Epub 2007 Mar 9.

Association between length of residence and cardiovascular disease risk factors among an ethnically diverse group of United States immigrants.

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Department of Medicine, Division of General Internal Medicine & Center for Health Disparities Research, Medical University of South Carolina, 135 Rutledge Avenue, Room 280H, Charleston, SC 29425, USA.



Although differences in cardiovascular disease (CVD) risk factors between immigrants and nonimmigrants have been examined previously, the effect of acculturation on CVD risk factors in immigrants has been less well studied.


To determine the association between length of U.S. residence (proxy for acculturation) and major CVD risk factors.


Data on 5,230 immigrant adults from the 2002 National Health Interview Survey (NHIS) was analyzed. Primary independent variable was length of U.S. residence < 10, 10 to < 15, and > or = 15 years. Main outcome measures included obesity, hypertension, diabetes, hyperlipidemia, smoking, and physical inactivity. Multiple logistic regression was used to assess the association between length of residence and odds of multiple CVD risk factors adjusting for confounders. SAS-callable SUDAAN was used for statistical analysis.


Among the patients, 55.4% were obese, 17.3% had hypertension, 15.9% had hyperlipidemia, 6.6% had diabetes, 79.3% were physically inactive, and 14.3% were smokers. Using < 10 years as reference, those with length of residence > or = 15 years were more likely to be obese (OR 1.31, 95% CI 1.03-1.65), have hyperlipidemia (OR 1.59, 95% CI 1.14-2.22), and be smokers (OR 1.39, 95% CI 1.04-1.85). Length of residence > or = 15 years was associated with decreased odds of sedentary lifestyle (OR 0.63, 95% CI 0.47-0.84). Length of residence > or = 15 years was not associated with odds of having diabetes (OR 1.40, 95% CI 0.78-2.51) or hypertension (OR 1.21, 95% CI 0.86-1.71).


Among immigrants from diverse ethnic backgrounds, longer length of residence in the United States is associated with increased odds of obesity, hyperlipidemia, and cigarette smoking even after adjusting for relevant confounding factors.

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