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Briggs Early K, Valencia SI, Stendell-Hollis N, Klyve D, Gee DL. Hypertension Prevalence and Related Risk Factors Among Mexican American Adults Are Increasing: National Health and Nutrition Examination Survey 1999 to 2018. J Am Heart Assoc 2024; 13:e030126. [PMID: 38818945 DOI: 10.1161/jaha.123.030126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/15/2024] [Indexed: 06/01/2024]
Abstract
BACKGROUND Acculturation affects hypertension prevalence among Hispanic people, but there have been no recent analyses specifically focused on Mexican American (MA) people. We sought to determine age-adjusted hypertension prevalence, abdominal obesity, and acculturation trends among MA adults and non-Hispanic White adults. METHODS AND RESULTS Data from the NHANES (National Health and Nutrition Examination Survey) were analyzed in 2-year increments to observe trends in hypertension and risk factors (age, sex, body mass index, smoking status, abdominal obesity, waist-to-height ratio (WHtR), education, and income). Acculturation was based on three commonly used measures. The sample included 30 920 adults. Age-adjusted hypertension prevalence is higher in MA adults (52.7%) than White adults (48.3%). Hypertension risk factors-age, obesity prevalence, WHtR, acculturation-all significantly increased among MA adults, while smoking declined. Higher acculturation scores increased hypertension likelihood (odds ratio [OR], 1.44 [95% CI, 0.91-1.97]) for MA adults compared with those with lower acculturation scores. White adults with elevated WHtR >0.5 had a 40% higher risk of hypertension than those with WHtR <0.5, but among MA adults, elevated WHtR did not increase risk for hypertension. There was a significant increase in hypertension prevalence among MA adults from 2003 to 2018 at an average biennial rate of 2.23%. There was no change in hypertension prevalence among White adults from 1999 to 2018. CONCLUSIONS Over 20 years of NHANES, more highly acculturated MA adults were at greater risk for hypertension, despite declines in smoking and controlling for age, sex, obesity status, education, and income. Finding ways to promote more traditional lifestyle and eating habits for MA adults could be a beneficial approach to reducing hypertension risk factors in this population.
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Affiliation(s)
- Kathaleen Briggs Early
- Department of Biomedical Sciences Pacific Northwest University of Health Sciences Yakima WA USA
| | - Sandra I Valencia
- Department of Health Sciences Central Washington University Ellensburg WA USA
| | | | - Dominic Klyve
- Department of Mathematics Central Washington University Ellensburg WA USA
| | - David L Gee
- Department of Health Sciences Central Washington University Ellensburg WA USA
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Higgins V. Ethnic density and area-deprivation effects on central obesity among ethnic minority people in England-A cross-sectional, multi-level analysis. FRONTIERS IN EPIDEMIOLOGY 2022; 2:1000155. [PMID: 38455306 PMCID: PMC10910919 DOI: 10.3389/fepid.2022.1000155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Accepted: 09/20/2022] [Indexed: 03/09/2024]
Abstract
Background Central obesity is a risk factor for many health conditions, and it disproportionately affects some ethnic minority groups. Research has shown that there is an association between area environments and obesity, but no studies have explored the association between co-ethnic density and central obesity in the UK (United Kingdom). This paper addresses the following research question: Does the relationship between co-ethnic density/area deprivation and waist circumference differ by ethnic group in England? Methods Data come from 4 years of the cross-sectional Health Survey for England (1998, 1999, 2003, 2004) and linked area-level data from the 2001 Census. More recent data on objectively measured central obesity for a nationally representative sample of ethnic minorities does not exist. Multi-level modeling methods account for individual-level and area-level factors. Interaction models test the effect of area deprivation and co-ethnic density for each ethnic group compared with the White reference group. Results For women, the relationship between area deprivation and waist circumference does not vary by ethnic group. For Indian and Bangladeshi men there is a decrease in waist circumference as area deprivation increases. There is an increase in waist circumference as co-ethnic density increases for Black Caribbean women. For Indian men there is a decrease in waist circumference as co-ethnic density increases. Conclusions Further research is needed to understand the mechanisms through which (1) increasing area-deprivation is protective for Indian and Bangladeshi men and (2) increasing co-ethnic density is associated with an increase in waist circumference for Black Caribbean women but a decrease in waist circumference among Indian men. Each of these results are important because (1) Indian and Bangladeshi men have an increased risk of the metabolic syndrome, which is linked to central obesity, and (2) Black Caribbean women have a higher risk of central obesity than the general population in England.
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Affiliation(s)
- Vanessa Higgins
- Cathie Marsh Institute, University of Manchester, Manchester, United Kingdom
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McArdle CE, Bokhari H, Rodell CC, Buchanan V, Preudhomme LK, Isasi CR, Graff M, North K, Gallo LC, Pirzada A, Daviglus ML, Wojcik G, Cai J, Perreira K, Fernandez-Rhodes L. Findings from the Hispanic Community Health Study/Study of Latinos on the Importance of Sociocultural Environmental Interactors: Polygenic Risk Score-by-Immigration and Dietary Interactions. Front Genet 2021; 12:720750. [PMID: 34938310 PMCID: PMC8685455 DOI: 10.3389/fgene.2021.720750] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 09/08/2021] [Indexed: 01/05/2023] Open
Abstract
Introduction: Hispanic/Latinos experience a disproportionate burden of obesity. Acculturation to US obesogenic diet and practices may lead to an exacerbation of innate genetic susceptibility. We examined the role of gene-environment interactions to better characterize the sociocultural environmental determinants and their genome-scale interactions, which may contribute to missing heritability of obesity. We utilized polygenic risk scores (PRSs) for body mass index (BMI) to perform analyses of PRS-by-acculturation and other environmental interactors among self-identified Hispanic/Latino adults from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Methods: PRSs were derived using genome-wide association study (GWAS) weights from a publicly available, large meta-analysis of European ancestry samples. Generalized linear models were run using a set of a priori acculturation-related and environmental factors measured at visit 1 (2008-2011) and visit 2 (2014-2016) in an analytic subsample of 8,109 unrelated individuals with genotypic, phenotypic, and complete case data at both visits. We evaluated continuous measures of BMI and waist-to-hip ratio. All models were weighted for complex sampling design, combined, and sex-stratified. Results: Overall, we observed a consistent increase of BMI with greater PRS across both visits. We found the best-fitting model adjusted for top five principal components of ancestry, sex, age, study site, Hispanic/Latino background genetic ancestry group, sociocultural factors and PRS interactions with age at immigration, years since first arrival to the United States (p < 0.0104), and healthy diet (p < 0.0036) and explained 16% of the variation in BMI. For every 1-SD increase in PRS, there was a corresponding 1.10 kg/m2 increase in BMI (p < 0.001). When these results were stratified by sex, we observed that this 1-SD effect of PRS on BMI was greater for women than men (1.45 vs. 0.79 kg/m2, p < 0.001). Discussion: We observe that age at immigration and the adoption of certain dietary patterns may play a significant role in modifying the effect of genetic risk on obesity. Careful consideration of sociocultural and immigration-related factors should be evaluated. The role of nongenetic factors, including the social environment, should not be overlooked when describing the performance of PRS or for promoting population health in understudied populations in genomics.
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Affiliation(s)
- Cristin E. McArdle
- Department of Biobehavioral Health, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States,*Correspondence: Cristin E. McArdle,
| | - Hassan Bokhari
- Department of Biobehavioral Health, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States
| | - Clinton C. Rodell
- Carey Business School, Johns Hopkins University, Baltimore, MD, United States
| | - Victoria Buchanan
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Liana K. Preudhomme
- Department of Psychology, University of Miami, Coral Gables, FL, United States
| | - Carmen R. Isasi
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Mariaelisa Graff
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Kari North
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States,Carolina Center for Genome Sciences, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Amber Pirzada
- Institute for Minority Health Research, Carle Illinois College of Medicine, University of Illinois at Urbana–Champaign, Champaign, IL, United States
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, United States
| | - Genevieve Wojcik
- Department of Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Krista Perreira
- Department of Social Medicine, University of North Carolina School of Medicine, Chapel Hill, NC, United States
| | - Lindsay Fernandez-Rhodes
- Department of Biobehavioral Health, College of Health and Human Development, The Pennsylvania State University, University Park, PA, United States,Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
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Reyes-Ortiz CA, Eschbach K, Zhang DD, Goodwin JS. Neighborhood composition and cancer among Hispanics: tumor stage and size at time of diagnosis. Cancer Epidemiol Biomarkers Prev 2009; 17:2931-6. [PMID: 18990733 DOI: 10.1158/1055-9965.epi-07-0430] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND We have previously reported that cancer incidence for lung, female breast, and colon and rectum for Hispanics decreases with increasing percentage of Hispanics at the census tract. In contrast, cervical cancer incidence increases with increasing percentage of Hispanics at the census tract. METHODS In this study, we investigate the hypothesis that Hispanics living in census tracts with high percentages of Hispanics are diagnosed with more advanced cancer, with respect to tumor size and stage of diagnosis. Data from the Surveillance, Epidemiology, and End Results registry and the U.S. Census Bureau were used to estimate the odds of diagnosis at a "late" stage (II, III, IV) versus "early" stage (I) and breast cancer tumor size among Hispanics as a function of census tract percent Hispanic. Hispanic ethnicity in the Surveillance, Epidemiology, and End Results registry was identified by medical record review and Hispanic surname lists. The study also used income of Hispanics living in the census tract and controlled for age at diagnosis and gender. RESULTS We found that Hispanics living in neighborhoods with higher density of Hispanic populations were more likely to be diagnosed with late-stage breast, cervical, or colorectal cancer, and to have a larger tumor size of breast cancer. CONCLUSIONS Our findings suggest that the benefits of lower cancer incidence in high tract percent Hispanics are partially offset by poorer access and reduced use of screening in conjunction with lower income, poorer health insurance coverage, and language barriers typical of these communities.
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Affiliation(s)
- Carlos A Reyes-Ortiz
- School of Public Health, University of North Texas, Health Sciences Center, Fort Worth, TX 76107-2699, USA.
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