Foreign born immigrants to the United States have a lower risk of cardiovascular disease than their U.S.-born counterparts; however, that advantage diminishes the longer they live in the U.S., according to a study presented at the American College of Cardiology's Middle East 2025 Together with 16th Emirates Cardiac Society Conference taking place October 3-5, 2025, in Dubai, UAE.
"We see that as immigrants are exposed to U.S. dietary and lifestyle habits for prolonged periods of time, it has a negative effect on their heart health," said Krishna Moparthi, a medical student at John. F. Kennedy University School of Medicine and co-author of the study. "There is a need for targeted public health interventions that address the evolving cardiovascular health risks among immigrant populations and raise awareness on effective prevention strategies."
Researchers analyzed data from 15,965 adults in the 2011-2016 National Health and Nutrition Examination Survey (NHANES), focusing on cardiovascular disease risk factors including BMI, diabetes, hypertension, dyslipidemia and smoking. Participants were categorized by U.S.-born or foreign-born status and further segmented by how long they have lived in the U.S. (less than 15 years vs. more than 15 years).
They found 86.4% of U.S.-born individuals and 80.1% of foreign-born individuals had at least one CVD risk factor. Foreign-born adults residing in the U.S. for less than 15 years had a lower adjusted prevalence of hypertension (38.3% vs. 48.5%), hypercholesterolemia (27.8% vs. 30%), and smoking (12.5% vs. 19.9%) compared to U.S.-born adults. However, foreign-born individuals living in the U.S. for more than 15 years had an increased prevalence of diabetes (15.4% vs. 11.2%) and hypercholesterolemia (29.4% vs. 30%) compared to their U.S.- born counterparts.
The study also highlighted that foreign-born, non-Hispanic Asian adults had a significantly higher prevalence of diabetes (14.5% vs. 6%) and a lower prevalence of smoking (8.2% vs. 12.5%) compared to U.S.-born, non-Hispanic Asians.
According to researchers, there are several reasons why immigrants' CVD risk is rising the longer they live in the U.S.
- Lifestyle acculturation: Over time, immigrants may adopt dietary patterns higher in processed foods, sugars and fats, along with more sedentary behaviors.
- Stress and socioeconomic factors: Chronic stressors such as discrimination, financial hardship or unstable work conditions can worsen cardiovascular risk.
- Loss of protective cultural practices: Traditional diets, physical activity habits and community/social support networks that initially confer health benefits may decline with prolonged U.S. residence.
- Health care access and utilization: Barriers to preventive care can delay diagnosis or treatment, contributing to rising risk factors.
Researchers said clinicians should consider an immigrant's duration of residence in the U.S. as a meaningful factor in immigrant patients' risk profiles and emphasize early screenings, culturally sensitive counseling and preventive interventions to preserve heart health.
"Immigrants arrive with a cardiovascular health advantage, but this fades the longer they reside in the U.S. due to acculturation, stress and lifestyle changes," Moparthi said. "Immigrants should proactively protect their health through screenings and maintaining protective behaviors, while clinicians must recognize duration of U.S. residence as a risk factor and provide culturally tailored prevention strategies."
