Myocardial infarction in Mexican-Americans and non-Hispanic whites. The San Antonio Heart Study.

Abstract

Mexican-American men experience reduced cardiovascular mortality compared with non-Hispanic white men. There is no corresponding ethnic difference in cardiovascular mortality in women. The difference in men could result either from a lower incidence of cardiovascular disease or a lower case fatality rate among Mexican-Americans. Although the incidence of cardiovascular disease in Mexican-Americans is unknown, we have collected data on prevalence of myocardial infarction in 5,148 individuals examined in the San Antonio Heart Study, a population-based survey of cardiovascular disease conducted between 1979 and 1988 in Mexican-Americans and non-Hispanic whites aged 25-64 years. Myocardial infarction was assessed by Minnesota-coded electrocardiograms and by a self-reported history of a physician-diagnosed heart attack. For both end points, the age-adjusted prevalence of myocardial infarction was lower in Mexican-American men than in non-Hispanic white men. After adjustment for age and diabetes status (present/absent), the odds of a myocardial infarction, as defined by either criterion, was approximately one third lower in Mexican-American men than in non-Hispanic white men (p = 0.06). In women, the prevalence of both myocardial infarction end points was slightly higher in Mexican-Americans than in non-Hispanic whites, although neither of these differences was significant. Although the ethnic differences in prevalence in this study were not statistically significant, their pattern parallels the pattern in the mortality due to cardiovascular diseases. Therefore, the results support the hypothesis that the reduced cardiovascular mortality rate observed in Mexican-American men reflects a lower incidence of myocardial infarction rather than a reduced case fatality rate because the latter would result in a higher prevalence.

Cardiovascular Disease Among Hispanics and Non-Hispanics in the Chronic Renal Insufficiency Cohort (CRIC) Study

“…In the Multi-Ethnic Study of Atherosclerosis (MESA), Hispanics were similarly almost twice as likely as non-Hispanic Caucasians to have LVH after adjustment for hypertension and other covariates (28). These results have clinical relevance because LVH is known to be an independent predictor of cardiovascular morbidity and mortality, and, therefore, more aggressive BP control among Hispanics could contribute to reducing LVH among this group (25,30).…”

Prognostic value of the computerized ECG in Hispanics

“…8 This, however, does not discount the possibility that the prevalence of cardiovascular disease is lower in Hispanics. The lower incidence of myocardial infarction 9 and lower calcium scores 10 suggest this may be the case. Our findings that Hispanics have a lower prevalence of pathologic Q-waves as well as less ST depression and lower CIIS support this theory.…”

“…The San Antonio Heart Study suggested that Hispanics have a lower incidence of myocardial infarction. 9 Lower coronary calcium scores have also provided indirect evidence that the prevalence of coronary artery disease (CAD) is lower in Hispanics. 10 Studies reporting differences in ECG findings between Hispanics and non-Hispanics are scarce and small in scale.…”

National Cholesterol Education Program Versus World Health Organization Metabolic Syndrome in Relation to All-Cause and Cardiovascular Mortality in the San Antonio Heart Study

“…Details of the study design have been previously published. [7][8][9] The Institutional Review Board of the University of Texas Health Science Center at San Antonio approved the study, and all subjects gave informed consent.…”