Status of Cardiovascular Disease and Stroke in Hispanics/Latinos in the United States

Abstract

Background and Purpose This American Heart Association (AHA) scientific statement provides a comprehensive overview of current evidence on the burden cardiovascular disease (CVD) among Hispanics in the United States. Hispanics are the largest minority ethnic group in the United States, and their health is vital to the public health of the nation and to achieving the AHA’s 2020 goals. This statement describes the CVD epidemiology and related personal beliefs and the social and health issues of US Hispanics, and it identifies potential prevention and treatment opportunities. The intended audience for this statement includes healthcare professionals, researchers, and policy makers. Methods Writing group members were nominated by the AHA’s Manuscript Oversight Committee and represent a broad range of expertise in relation to Hispanic individuals and CVD. The writers used a general framework outlined by the committee chair to produce a comprehensive literature review that summarizes existing evidence, indicate gaps in current knowledge, and formulate recommendations. Only English-language studies were reviewed, with PubMed/MEDLINE as our primary resource, as well as the Cochrane Library Reviews, Centers for Disease Control and Prevention, and the US Census data as secondary resources. Inductive methods and descriptive studies that focused on CVD outcomes incidence, prevalence, treatment response, and risks were included. Because of the wide scope of these topics, members of the writing committee were responsible for drafting individual sections selected by the chair of the writing committee, and the group chair assembled the complete statement. The conclusions of this statement are the views of the authors and do not necessarily represent the official view of the AHA. All members of the writing group had the opportunity to comment on the initial drafts and approved the final version of this document. The manuscript underwent extensive AHA internal peer review before consideration and approval by the AHA Science Advisory and Coordinating Committee. Results This statement documents the status of knowledge regarding CVD among Hispanics and the sociocultural issues that impact all subgroups of Hispanics with regard to cardiovascular health. In this review, whenever possible, we identify the specific Hispanic subgroups examined to avoid generalizations. We identify specific areas for which current evidence was less robust, as well as inconsistencies and evidence gaps that inform the need for further rigorous and interdisciplinary approaches to increase our understanding of the US Hispanic population and its potential impact on the public health and cardiovascular health of the total US population. We provide recommendations specific to the 9 domains outlined by the chair to support the development of these culturally tailored and targeted approaches. Conclusions Healthcare professionals and researchers need to consider the impact of culture and ethnicity on health behavior and ultimately health outcomes. There is a...

Trends in Racial/Ethnic Disparities in Cardiovascular Health Among US Adults From 1999–2012

“…For example, there were significantly higher smoking scores (ie, fewer smokers) among Mexican‐American women. Indeed, the lower rates of CVD mortality among Hispanics as compared with NH whites—known as the Hispanic Paradox—are contrary to the generally higher risk factor burden and CVD incidence among Hispanics 3. It has been posited that cultural context may contribute to this particular CVH resiliency, despite disparate access to some health resources 23.…”

“…Non‐Hispanic (NH) blacks have higher incidence of coronary heart disease, heart failure, stroke, and overall CVD mortality as compared with NH whites 1, 2. CVD burden in Hispanics as compared with NH whites is mixed; whereas Hispanics have lower overall CVD mortality, incidence rates for coronary heart disease and stroke appear to be higher 3. However, US Hispanics are an aggregated ethnicity that includes multiple heritage groups, and previous research has shown highly varying prevalence of CVD and CVD risk factor prevalence by Hispanic background 4.…”

Nativity Status and Cardiovascular Disease Mortality Among Hispanic Adults

“…The term Hispanic refers to a heterogeneous group of individuals of any race who have origins in Mexico, the Caribbean, Central America, South America, or other Spanish‐speaking countries 1. Although Hispanic persons share the same Spanish language, their histories of migration into the United States differ, affecting patterns of settlement, social profiles, and health factors 2, 3, 4, 5, 6.…”

Hispanic Secondary Stroke Prevention Initiative Design: Study Protocol and Rationale for a Randomized Controlled Trial (Preprint)

“…Research indicates that a majority of recurrent stroke cases can be prevented by better control of modifiable risk factors [5]. However, Hispanics (a term we used interchangeably with Latinos) face a disparate burden of stroke and stroke risk factors in comparison to non-Hispanic whites [6,7,8]. For example, hypertension, diabetes, and limited physical activity account for more strokes among Hispanics than any other racial or ethnic group [9,10,11].…”