U.S.-born adults are more likely to report having been diagnosed with coronary heart disease and stroke than their immigrant peers, a new federal study shows.

The study’s lead author Dr. Jing Fang, a cardiovascular epidemiologist for the Centers for Disease Control and Prevention, said learning that coronary heart disease and stroke risk varied by country and region suggests there are social and cultural factors that impact cardiovascular health.

For the study, published Wednesday in the Journal of the American Heart Association, researchers at the CDC analyzed health data gathered between 2006 and 2014 from 258,862 adults who participated in the National Health Interview Survey, a long-running health study of Americans that began more than 50 years ago. Of these adults, 16.4 percent had been born abroad.

Nearly 57 percent of immigrants in the survey were from Mexico, Central America, South America and the Caribbean. About 17 percent had been born in Asia and about 16 percent in Europe. Immigrants from Africa and the Indian subcontinent were also included in the report.

The prevalence of coronary heart disease among U.S.-born adults and their immigrant peers varied by birthplace. For example, 6.4 percent of U.S.-born adults reported having been diagnosed with coronary heart disease, compared with 5.4 percent of adults born in Europe, 5.1 percent born in the Indian subcontinent and 5 percent born in Mexico, Central America and the Caribbean. Immigrants born in Africa were the least likely to have coronary heart disease.

Similar differences were seen in stroke diagnoses. The study found 2.7 percent of U.S. born adults reported having had a stroke compared to 2.3 percent of adults born in Mexico, Central America, and the Caribbean and 1.9 percent born in Africa.

The CDC analysis is among recent studies comparing the cardiovascular health of U.S.- and foreign-born adults.

A 2016 study that used data from the Multiethnic Study of Atherosclerosis found that immigrants who had lived in the U.S. the longest had the poorest cardiovascular health. That study also found the cardiovascular health of immigrants who had lived in the U.S. for less than 10 years declined more rapidly than those who had lived in the country for more than 10 years.

The new study confirms results from other studies that show immigrant adults living in the U.S. are less likely to develop coronary heart disease or have a stroke than their U.S.-born peers, said Dr. Alain G. Bertoni, chair of the department of epidemiology and prevention at Wake Forest School of Medicine, who was not involved in the new research.

Bertoni, a longtime cardiovascular disease researcher and a co-author of the 2016 study, found it striking that Asian men reported a much lower risk of coronary heart disease than any of the other men surveyed. He also found it noteworthy that adults born in Mexico, Central America and the Caribbean were more likely to be diabetic than those born in the U.S. and other countries and regions.

“It intrigues us to look further to figure out what can we do to keep people healthier,” Bertoni said. “This is not completely explainable by genetic risk.”

Bertoni, who studies diabetes, said the study should prompt cardiovascular disease researchers to learn more about the health-related habits, such as diet and exercise, immigrants had before moving to the U.S. as well as whether and how their lifestyle changed the longer they lived in this country.

The research also suggests that public health officials need to do more than step up coronary heart disease and stroke prevention efforts in immigrant communities. “The implications of this study include treatment for these conditions as well,” said Fang.

The findings should also remind all American adults that [coronary] heart disease and stroke are not inevitable. “Everybody should [know] the risk factors [as well as know] what you can change on a personal level to lower your risk,” Bertoni said.

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