Background With an increasing foreign-born population in the United States, cardiovascular risk reduction through effective lipid treatment strategy is precluded by limited lipid profile information. Objective This study compares the patterns of lipid abnormalities of foreign-born and US-born patients treated by a single medical group. Methods We conducted a medical record review of 53,361 US-born and 6430 foreign-born patients in 2010. Results Compared with US-born, a higher proportion of foreign-born patients are younger than 40 years (26% vs 14%), receive Medicaid (24% vs 8%), and are less likely to be obese (26% vs 43%). More foreign-born patients have diabetes (25% vs 22%), are poor (4.7% vs 3.6%), and not on lipid-lowering drugs (63% vs 56%). Place of birth is not associated with total cholesterol levels. Adjusted for social and demographic characteristics, however, foreign-born are more likely than US-born to have elevated low-density lipoprotein cholesterol (adjusted difference, 2.1; 95% CI, 0.6-3.7), depressed high-density lipoprotein cholesterol (adjusted difference, 6.1; 95% CI, 4.4-7.8), and elevated triglycerides (adjusted difference, 2.4; 95% CI, 0.8-4.1). Foreign-born patients, on lipid-lowering medications, are more likely to still have elevated levels of low-density lipoprotein cholesterol (adjusted difference, 3.5; 95% CI, 1.4-5.6). Conclusion Despite having a similar distribution of total cholesterol as their US-born counterparts, the other lipid fractions among foreign-born patients are more likely to be pathologic. Therefore, dyslipidemia screening tests need to include the lipid subfractions. The higher prevalence of dyslipidemias, both among foreign-born patients with and without lipid-lowering medications, challenges medical groups to intensify effective lipid treatment strategies.
Bibliographical noteFunding Information:
This research was supported by The HealthPartners Research Foundation and The Heart Disease and Stroke Prevention Unit at the Minnesota Department of Health from a Capacity Building-Cooperative Agreement grant from the Centers for Disease Control and Prevention, and from the National Institutes of Health training grant T32 HL69764. The funder had no role in the design of the study and the analysis and interpretation of data. The authors report no financial disclosure or conflict of interest.
- High-density lipoprotein cholesterol
- Low-density lipoprotein cholesterol
- Total cholesterol