BackgroundAlthough African immigrants represent a large and growing segment of the U.S. population, there are little or no data available on the prevalence of cardiovascular disease (CVD) risk factors among this diverse population. This study compared the prevalence of self-reported CVD risk factors and health behaviors and examined the associations between immigration related characteristics and CVD risk factors and health behaviors across six African immigrants groups.MethodsData were from 996 African immigrants in the U.S., (37.9% Somalis; 26.8% Ethiopians; 14% Liberians; 8.5% Sudanese; 5.1% Kenyans and 7.8% others group) from a cross-sectional survey conducted in the Twin cities of Minnesota. Logistic regression models estimated the associations of demographic characteristics, and immigration-related factors (length of stay in the United states, English proficiency, income and health insurance) with prevalence of CVD risk factors (overweight/obese; hypertension and diabetes mellitus) and self-reported health behaviors (cigarette smoking, physical inactivity, conscious effort to exercise and eating a healthy diet).ResultsWe found a relatively low self-reported prevalence of diabetes, hypertension, and smoking. However, significant differences were noted by country of origin. Using Somalis as our referent country of origin group, we found that Liberians and Kenyans were more likely to report having diabetes or hypertension. On all measures of health behaviors, Liberians were more likely to engage in more health protective behaviors than other individuals.ConclusionsAlthough African immigrants have different prevalence rates for CVD risk factors and health behaviors, there is a need to further explore the differences observed by country of emigration.
Cardiac allograft vasculopathy remains a major challenge to long-term survival after heart transplantation. Endothelial injury and dysfunction, as a result of multifactorial immunologic and nonimmunologic insults in the donor and the recipient, are prevalent early after transplant and may be precursors to overt cardiac allograft vasculopathy. Current strategies for managing cardiac allograft vasculopathy, however, rely on the identification and treatment of established disease. Improved understanding of mechanisms leading to endothelial dysfunction in heart transplant recipients may provide the foundation for the development of sensitive screening techniques and preventive therapies.
Arterial elasticity is a functional biomarker that has predictive value for cardiovascular morbidity and mortality in nontransplant populations. There is little information regarding arterial elasticity in heart transplant recipients. This study aimed to characterize small (SAE) and large (LAE) artery elasticity in heart transplant recipients in comparison with an asymptomatic population free of overt cardiovascular disease. A second goal was to identify demographic and clinical factors associated with arterial elasticity in this unique population. Methods: Arterial pulse waveform was registered noninvasively at the radial artery in 71 heart transplant recipients between 2008 and 2010. SAEs and LAEs were derived from diastolic pulse contour analysis. Comparisons were made to a healthy cohort of 1,808 participants selected from our prevention clinic database. Multiple regression analyses were performed to evaluate associations between risk factors and SAE and LAE within the heart transplant recipients. Results: LAE and SAE were significantly lower in heart transplant recipients than in the normal cohort (P , 0.01 and P , 0.0001, respectively). Female sex and history of ischemic cardiomyopathy were significantly associated with reduced LAE and SAE. Older age and the presence of moderate cardiac allograft vasculopathy were also significantly associated with reduced SAE. Transplant duration was associated with increased SAE. Conclusion: Heart transplants are associated with peripheral endothelial dysfunction and arterial stiffness, as demonstrated by a significant reduction in SAE and LAE when compared with a healthy population. Furthermore, cardiac allograft vasculopathy is associated with a significant reduction in SAE, suggesting a potential use in screening heart transplant recipients at risk for developing this complication.
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