Association of acculturation with cardiac structure and function among Hispanics/Latinos: a cross-sectional analysis of the echocardiographic study of Latinos

BMJ Open. 2019 Nov 28;9(11):e028729. doi: 10.1136/bmjopen-2018-028729.


Objective: Hispanics/Latinos, the largest immigrant population in the USA, undergo the process of acculturation and have a large burden of heart failure risk. Few studies have examined the association of acculturation on cardiac structure and function.

Design: Cross-sectional.

Setting: The Echocardiographic Study of Latinos.

Participants: 1818 Hispanic adult participants with baseline echocardiographic assessment and acculturation measured by the Short Acculturation Scale, nativity, age at immigration, length of US residence, generational status and language.

Primary and secondary outcome measures: Echocardiographic assessment of left atrial volume index (LAVI), left ventricular mass index (LVMI), early diastolic transmitral inflow and mitral annular velocities.

Results: The study population was predominantly Spanish-speaking and foreign-born with mean residence in the US of 22.7 years, mean age of 56.4 years; 50% had hypertension, 28% had diabetes and 44% had a body mass index >30 kg/m2. Multivariable analyses demonstrated higher LAVI with increasing years of US residence. Foreign-born and first-generation participants had higher E/e' but lower LAVI and e' velocities compared with the second generation. Higher acculturation and income >$20K were associated with higher LVMI, LAVI and E/e' but lower e' velocities. Preferential Spanish-speakers with an income <$20K had a higher E/e'.

Conclusions: Acculturation was associated with abnormal cardiac structure and function, with some effect modification by socioeconomic status.

Keywords: acculturation; echocardiogram; hispanics/latinos; socioeconomic status.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acculturation*
  • Adolescent
  • Adult
  • Aged
  • Cardiovascular Diseases / diagnostic imaging
  • Cardiovascular Diseases / ethnology*
  • Cross-Sectional Studies
  • Echocardiography
  • Family Characteristics / ethnology*
  • Female
  • Hispanic or Latino
  • Humans
  • Language
  • Latin America / ethnology
  • Linear Models
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Residence Characteristics / statistics & numerical data*
  • Social Class
  • United States / epidemiology
  • Young Adult