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Cardiovascular Health in St. Louis Bosnian-Americans
Maximillian T Bourdillon1, Asad S Akhter1, Dejan Vrtikapa1
1Center for Comprehensive Cardiovascular Care, Saint Louis University School of Medicine, 3635 Vista Ave, DT 13, Saint Louis, MO, USA.
Insights
Bosnian-Americans show elevated cardiovascular risk, with over 26% considered high-risk, including those with existing coronary heart disease (CHD). Culturally tailored interventions addressing diet, exercise, and smoking are recommended.
Area of Science:
- Public Health
- Cardiology
- Epidemiology
Background:
- Cardiovascular disease is a leading cause of death in Bosnia and Herzegovina, accounting for nearly 50% of all deaths.
- The cardiovascular health profile of Bosnian-Americans, a significant refugee population, remains under-characterized.
- St. Louis hosts the largest non-European Bosnian-American resettlement community, making it a key site for health assessments.
Purpose of the Study:
- To assess and quantify the cardiovascular risk within the Bosnian-American community in St. Louis.
- To identify prevalent cardiovascular risk factors and lipid abnormalities in this population.
- To inform the development of culturally sensitive public health interventions.
Main Methods:
- Seven community-based screenings were conducted specifically for Bosnian-Americans.
- Cardiovascular risk was calculated using established risk stratification (low <10%, moderate 10-20%, high >20%).
- Individuals with self-reported coronary heart disease (CHD) or risk equivalent were categorized as high-risk.
Main Results:
- Out of 250 screened individuals, 51% (n=128) consented to participate.
- Prevalence of risk factors included 21% smokers, 33% obesity, and 33% hypertension.
- High cardiovascular risk was found in 5.7% of subjects, rising to 26.6% when including CHD or risk equivalents.
- Lipid abnormalities were common: 29.0% had elevated triglycerides and 50.0% had low HDL cholesterol.
Conclusions:
- Bosnian-Americans exhibit a greater ten-year hard coronary heart disease (CHD) risk compared to the general American population.
- Community-based screening effectively identified significant cardiovascular risk and prevalent risk factors.
- Culturally tailored lifestyle interventions focusing on diet, physical activity, and smoking cessation are warranted.
Abstract:
In Bosnia and Herzegovina, cardiovascular disease accounts for nearly 50% of deaths. Cardiovascular health of resettled Bosnian-Americans has not been well-characterized. Our study aimed to quantify cardiovascular risk in Bosnian-Americans in St. Louis, the largest non-European center of resettlement. Seven community screenings focused on Bosnian-Americans were held. Cardiovascular risk was calculated to stratify individuals into low (<10%), moderate (10-20%), and high (>20%) risk. Those with self-reported coronary heart disease (CHD) or risk equivalent were considered high-risk. Two-hundred fifty Bosnian-Americans were screened; 51% (n = 128) consented to the IRB-approved study. Twenty-one percent were smokers, 33% obese, and 33% had hypertension. Excluding risk equivalent individuals, 5.7% of subjects were high-risk, increasing to 26.6% when including high-risk equivalents. Lipid abnormalities include elevated triglycerides (29.0%) and low HDL (50.0%). Compared to general American population studies, Bosnian-Americans have greater ten-year hard CHD risk. A community-based approach identified potential culturally-based lifestyle interventions including diet, exercise, and smoking.
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