Background Multiple dietary patterns haven been recommended by 2015–2020 Dietary Guidelines for Americans for the prevention of cardiovascular disease (CVD). The adherence to these patterns and its relationship with risk of CVD remain unclear in the US Hispanic/Latino population. Objectives We aimed to evaluate three healthy eating patterns measured by three dietary pattern scores (the Alternate Mediterranean diet (aMED), the Healthy Eating Index (HEI)-2015, and the healthful Plant-based Diet Index (hPDI)) across different Hispanic/Latino backgrounds and generations. We further examined the associations of these dietary scores with incident CVD in US Hispanics/Latinos. Methods We included 10,293 adult participants of US Hispanics/Latinos of six backgrounds (Mexican, Puerto Rican, Cuban, Dominican, Central American and South American), free of CVD or cancer at baseline, in the Hispanic Community Health Study/Study of Latinos. Dietary pattern scores were derived at the baseline visit using two 24-hour dietary recalls. The primary outcome was the major incident CVD (n = 232), comprised of coronary heart disease and stroke, during an average 6-year follow-up. Results Mean levels of all three dietary scores were significantly different across 6 Hispanic/Latino background groups (all P < 0.001), with highest (i.e., healthiest) in those of Mexican background and lowest in those of Puerto Rican background. Compared to non-mainland-US-born Hispanics/Latinos, mainland-US-born Hispanics/Latinos had significantly lower dietary scores (P < 0.001). Differences in dietary scores between mainland-US-born and non-mainland-US-born Hispanics/Latinos were majorly driven by differences in dietary intakes of healthy plant-based foods. After adjusting for multiple covariates, significantly lower risk ratios (95% CI) of CVD were observed for one standard deviation increment of the dietary scores, with 0.74 (0.60,0.91) for aMED, 0.80 (0.63,1.00) for HEI-2015, and 0.74 (0.60,0.93) for hPDI. Conclusions Although adherence to healthy eating patterns varies by Hispanic/Latino backgrounds and generations, greater adherence to these eating patterns is associated with lower risk of CVD across diverse US Hispanics/Latinos.

A 47-year-old female with a past history of hypertension, systemic lupus erythematosus, renal transplant and coronary artery disease status postpercutaneous coronary intervention, developed postcardiotomy shock with inferior ST elevations days after coronary artery bypass graft (CABG) surgery.