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Background  The number of African immigrants in the United States grew 40‐fold between 1960 and 2007, from 35 355 to 1.4 million, with a large majority from West Africa. This study sought to examine the prevalence of cardiovascular disease ( CVD ) risk factors and global  CVD  risk and to identify independent predictors of increased  CVD  risk among West African immigrants in the United States.    Methods and Results  This cross‐sectional study assessed West African (Ghanaian and Nigerian) immigrants aged 35–74 years in the Baltimore–Washington metropolitan area. The mean age of participants was 49.5±9.2 years, and 58% were female. The majority (95%) had ≥1 of the 6  CVD  risk factors. Smoking was least prevalent, and overweight or obesity was most prevalent, with 88% having a body mass index (in  kg/m 2 ) ≥25; 16% had a prior diagnosis of diabetes or had fasting blood glucose levels ≥126 mg/ dL . In addition, 44% were physically inactive. Among women, employment and health insurance were associated with odds of 0.09 (95%  CI  0.033–0.29) and 0.25 (95%  CI  0.09–0.67), respectively, of having a Pooled Cohort Equations estimate ≥7.5% in the multivariable logistic regression analysis. Among men, higher social support was associated with 0.90 (95%  CI  0.83–0.98) lower odds of having ≥3  CVD  risk factors but not with having a Pooled Cohort Equations estimate ≥7.5%.    Conclusions  The prevalence of  CVD  risk factors among West African immigrants was particularly high. Being employed and having health insurance were associated with lower  CVD  risk in women, but only higher social support was associated with lower  CVD  risk in men.

Sex Differences in Cardiovascular Disease Risk of Ghanaian‐ and Nigerian‐Born West African Immigrants in the United States: The Afro‐Cardiac Study