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Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors

BACKGROUND: We examined differences in blood pressure (BP) levels between first-generation immigrants and natives in adult residents in Northeast Italy, and investigated the role of lifestyle behaviors, body mass index (BMI), and education as potentially modifiable mediating factors. METHODS: We inc...

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Autores principales: Dalla Zuanna, Teresa, Batzella, Erich, Russo, Francesca, Pitter, Gisella, Canova, Cristina
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Netherlands 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468480/
https://www.ncbi.nlm.nih.gov/pubmed/37421555
http://dx.doi.org/10.1007/s44197-023-00136-x
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author Dalla Zuanna, Teresa
Batzella, Erich
Russo, Francesca
Pitter, Gisella
Canova, Cristina
author_facet Dalla Zuanna, Teresa
Batzella, Erich
Russo, Francesca
Pitter, Gisella
Canova, Cristina
author_sort Dalla Zuanna, Teresa
collection PubMed
description BACKGROUND: We examined differences in blood pressure (BP) levels between first-generation immigrants and natives in adult residents in Northeast Italy, and investigated the role of lifestyle behaviors, body mass index (BMI), and education as potentially modifiable mediating factors. METHODS: We included 20–69-year-old participants from the Health Surveillance Program of the Veneto Region (n = 37,710). Immigrants born in a high migratory pressure country (HMPC) were further grouped into geographical macro-areas. The outcomes were systolic BP (SBP) and hypertension. Multiple mediation analyses were performed to determine the contribution of each mediator of the SBP/migrant status association. RESULTS: Of the 37,380 subjects included, 8.7% were born in an HMPC. BMI, education, alcohol, sweets and meat consumption were included as potential mediators. A small advantage in SBP was seen for immigrants compared to natives (β =  – 0.71,95%CI  – 1.30;  – 0.10). The direct effect (net of the covariates) of immigrant status on SBP was a reduction of 1.62 mmHg (95%CI  – 2.25;  – 0.98). BMI played the highest suppressive role (β = 1.14,95%CI 0.99; 1.35), followed by education. Alcohol consumption amplified the health advantage of immigrants. The suppressing effect of BMI was particularly evident among women and North Africans compared to natives. Similar results were seen for hypertension rates. CONCLUSIONS: Although causation cannot be proven given the cross-sectional design, our findings identify BMI as the most effective target to preserve the health advantage of immigrants with respect to BP levels. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s44197-023-00136-x.
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spelling pubmed-104684802023-09-01 Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors Dalla Zuanna, Teresa Batzella, Erich Russo, Francesca Pitter, Gisella Canova, Cristina J Epidemiol Glob Health Research Article BACKGROUND: We examined differences in blood pressure (BP) levels between first-generation immigrants and natives in adult residents in Northeast Italy, and investigated the role of lifestyle behaviors, body mass index (BMI), and education as potentially modifiable mediating factors. METHODS: We included 20–69-year-old participants from the Health Surveillance Program of the Veneto Region (n = 37,710). Immigrants born in a high migratory pressure country (HMPC) were further grouped into geographical macro-areas. The outcomes were systolic BP (SBP) and hypertension. Multiple mediation analyses were performed to determine the contribution of each mediator of the SBP/migrant status association. RESULTS: Of the 37,380 subjects included, 8.7% were born in an HMPC. BMI, education, alcohol, sweets and meat consumption were included as potential mediators. A small advantage in SBP was seen for immigrants compared to natives (β =  – 0.71,95%CI  – 1.30;  – 0.10). The direct effect (net of the covariates) of immigrant status on SBP was a reduction of 1.62 mmHg (95%CI  – 2.25;  – 0.98). BMI played the highest suppressive role (β = 1.14,95%CI 0.99; 1.35), followed by education. Alcohol consumption amplified the health advantage of immigrants. The suppressing effect of BMI was particularly evident among women and North Africans compared to natives. Similar results were seen for hypertension rates. CONCLUSIONS: Although causation cannot be proven given the cross-sectional design, our findings identify BMI as the most effective target to preserve the health advantage of immigrants with respect to BP levels. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1007/s44197-023-00136-x. Springer Netherlands 2023-07-08 /pmc/articles/PMC10468480/ /pubmed/37421555 http://dx.doi.org/10.1007/s44197-023-00136-x Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) .
spellingShingle Research Article
Dalla Zuanna, Teresa
Batzella, Erich
Russo, Francesca
Pitter, Gisella
Canova, Cristina
Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors
title Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors
title_full Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors
title_fullStr Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors
title_full_unstemmed Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors
title_short Migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors
title_sort migrant status disparities in blood pressure: a multiple mediation analysis of modifiable factors
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10468480/
https://www.ncbi.nlm.nih.gov/pubmed/37421555
http://dx.doi.org/10.1007/s44197-023-00136-x
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