Hypertension, overweight/obesity, and diabetes among immigrants in the United States: an analysis of the 2010–2016 National Health Interview Survey

Abstract

BackgroundEthnic minority populations in the United States (US) are disproportionately affected by cardiovascular disease (CVD) risk factors, including hypertension, overweight/obesity, and diabetes. The size and diversity of ethnic minority immigrant populations in the US have increased substantially over the past three decades. However, most studies on immigrants in the US are limited to Asians and Hispanics; only a few have examined the prevalence of CVD risk factors across diverse immigrant populations. The prevalence of diagnosed hypertension, overweight/obesity, and diagnosed diabetes was examined and contrasted among a socioeconomically diverse sample of immigrants. It was hypothesized that considerable variability would exist in the prevalence of hypertension, overweight and diabetes.MethodsA cross-sectional analysis of the 2010–2016 National Health Interview Survey (NHIS) was conducted among 41,717 immigrants born in Europe, South America, Mexico/Central America/Caribbean, Russia, Africa, Middle East, Indian subcontinent, Asia and Southeast Asia. The outcomes were the prevalence of diagnosed hypertension, overweight/obesity, and diagnosed diabetes.ResultsThe highest multivariable adjusted prevalence of diagnosed hypertension was observed in Russian (24.2%) and Southeast Asian immigrants (23.5%). Immigrants from Mexico/Central America/Caribbean and the Indian subcontinent had the highest prevalence of overweight/obesity (71.5 and 73.4%, respectively) and diagnosed diabetes (9.6 and 10.1%, respectively). Compared to European immigrants, immigrants from Mexico/Central America/Caribbean and the Indian subcontinent respectively had higher prevalence of overweight/obesity (Prevalence Ratio (PR): 1.19[95% CI, 1.13–1.24]) and (PR: 1.22[95% CI, 1.14–1.29]), and diabetes (PR: 1.70[95% CI, 1.42–2.03]) and (PR: 1.78[95% CI, 1.36–2.32]). African immigrants and Middle Eastern immigrants had a higher prevalence of diabetes (PR: 1.41[95% CI, 1.01–1.96]) and PR: 1.57(95% CI: 1.09–2.25), respectively, than European immigrants —without a corresponding higher prevalence of overweight/obesity.ConclusionsImmigrants from Mexico/Central America/Caribbean and the Indian subcontinent bore the highest burden of overweight/obesity and diabetes while those from Southeast Asia and Russia bore the highest burden of hypertension.

Metabolite profiling paradoxically reveals favorable levels of lipids, markers of oxidative stress and unsaturated fatty acids in a diabetes susceptible group of Middle Eastern immigrants

“…The prevalence of hypertension has previously been shown to be lower in non-European immigrants living in Sweden, the majority of which are from the Middle East, as compared to native Swedes [23]. In line with this, the prevalence of hypertension was found to be similar in Americans originating from Europe and the Middle East, whereas T2D was more prevalent in the latter population [24]. Further, we have previously shown, in the larger MEDIM cohort including over 2000 individuals, a more favorable kidney function in the Iraqi immigrant than native Swedish population [25].…”

Disproportionate impact of the COVID-19 pandemic on immigrant communities in the United States

“…These organizations are often underfunded, limiting their ability to provide testing, management, and follow-up services to their patients. Second, lack of access to preventive medicine leads to increased risk of underlying health conditions such as obesity, hypertension, and diabetes-—comorbidities that have been linked to more severe COVID-19 manifestations [ 9 , 12 – 15 ]. In a national evaluation of health conditions in immigrant populations, nearly a third (27.7%) of those from Mexico, the Caribbean, and Central America had hypertension, 71.5% had obesity, and 9.6% had diabetes [ 15 ], compared with the age-adjusted prevalence of 45.4%, 42.4%, and 8.2%, respectively, in the US general population [ 16 ].…”

Current Pharmacological Treatment of Type 2 Diabetes Mellitus in Undocumented Migrants: Is It Appropriate for the Phenotype of the Disease?

“…More in general, the impact of non-communicable diseases (NCD) in these migrant populations is relevant, though many aspects are still unclear [7,10,11]; certainly, ethnic differences may play a role [12]. This is true also for T2D; its prevalence in migrants is high [13,14], but again ethnic differences are relevant [12], with this disease being more frequent in people of South Asian, African and African-Caribbean family origin [5,15]. T2D is more likely to be poorly controlled in migrants [16], and can be less intensely treated in migrants than in natives [17].…”