Purpose: Despite cross-sectional evidence that foreign-born United States (US) residents often have better health than US-born residents of similar race and/or ethnicity, we know little about overall cardiovascular risk progression over time among immigrants as they age in the US. Methods: Using longitudinal data from the Multiethnic Study of Atherosclerosis on 6446 adults aged 45-84 years at baseline, we examined how nativity and length of US residence related to change in cardiovascular health (CVH) and cardiovascular event incidence over 11-year follow-up. CVH was measured using the American Heart Association's CVH measure (range, 0-14; higher is better). Results: Immigrants, particularly those with shorter US residence, had better baseline CVH and lower cardiovascular event incidence than the US born. Baseline CVH scores ranged from 8.67 (8.42-8.92) among immigrants living in the US less than 10 years to 7.86 (7.76-7.97) among the US born. However, recent immigrants experienced the largest CVH declines over time: 10-year declines ranged from -1.04 (-1.27 to -0.80) among immigrants living in the US less than 10 years at baseline to -0.47 (-0.52 to -0.42) among the US born. Conclusions: Public health prevention efforts targeting new immigrants may help slow the deterioration of CVH and reduce future cardiovascular risk. © 2016 Elsevier Inc.

Cardiovascular risk factors immigrants Cardiovascular events Cohort studies

physical activity educational status lifestyle longitudinal study immigrant Life Style cardiovascular risk Chinese Caucasian cholesterol blood level survival analysis Cardiovascular Diseases sex ratio follow up human risk assessment middle aged Ethnic Groups medical society statistics and numerical data ethnic group time factor priority journal Aged Time Factors comparative study ethnology groups by age statistical significance Cross-Sectional Studies United States disease course cross-sectional study migrant Humans Hispanic cardiovascular disease Black person male Emigrants and Immigrants Acculturation Aged, 80 and over female very elderly cultural factor Incidence cholesterol Article glucose blood level major clinical study adult Sex Distribution age distribution glucose cohort analysis blood pressure measurement body mass Body Mass Index attitude to health pathophysiology