Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Diseases Among Hispanic/Latino Individuals of Diverse Backgrounds in the United States

Study Questions:

What is the prevalence of major cardiovascular disease (CVD) risk factors and outcomes among US Hispanic and Latino adults?

Methods:

Data for this study were collected from a multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos, which included individuals of Cuban (n = 2,201), Dominican (n = 1,400), Mexican (n = 6,232), Puerto Rican (n = 2,590), Central American (n = 1,634), and South American backgrounds (n = 1,022). Participants were ages 18-74 years, at time of enrollment (March 2008 through June 2011). CVD risk factors including hypercholesterolemia, hypertension, obesity, diabetes, and smoking were defined using national guidelines. The primary outcome of interest included CVD events, defined as coronary heart disease (CHD) and stroke. These outcomes were assessed through self-report.

Results:

A total of 15,079 participants were included in this study. The age-adjusted prevalence of CVD risk factors varied by Hispanic/Latino background. Obesity rates were highest among Puerto Rican participants (40.9% for men, 34.7% for women). Smoking rates were also highest among Puerto Rican participants (51.4% for men and 31.7% for women). Prevalence of hypercholesterolemia was highest among Central American men (54.9%) and Puerto Rican women (41.0%). Large proportions of participants (80% of men, 71% of women) had at least one risk factor. Age- and sex-adjusted prevalence of three or more risk factors was highest in Puerto Rican participants (25.0%), and significantly higher (p < 0.001) among participants with less education (16.1%), those who were US-born (18.5%), those who had lived in the United States 10 years or longer (15.7%), and those who preferred English (17.9%). Overall, self-reported CHD and stroke prevalence were low (4.2% and 2.0% in men; 2.4% and 1.2% in women, respectively). In multivariate-adjusted models, hypertension and smoking were directly associated with CHD in both sexes, as were hypercholesterolemia and obesity in women and diabetes in men (odds ratios [ORs], 1.5-2.2). For stroke, associations were positive with hypertension in both sexes, diabetes in men, and smoking in women (ORs, 1.7-2.6).

Conclusions:

The investigators concluded that among US Hispanic/Latino adults of diverse backgrounds, a sizeable proportion of men and women had adverse major risk factors. Adverse CVD risk profiles were higher among participants with Puerto Rican background, lower socioeconomic status, and higher levels of acculturation.

Perspective:

This thoughtful analysis incorporates critical factors when examining prevalence of CVD risk factors. By examining socioeconomic factors as well as background, and time residing in the US, these data provide important insights that can be used by public health experts to target prevention efforts to those at high risk for CVD. Future efforts may wish to include measurement of outcomes beyond self-report.

Clinical Topics: Dyslipidemia, Prevention, Homozygous Familial Hypercholesterolemia, Hypertension, Smoking

Keywords: Odds Ratio, Stroke, European Continental Ancestry Group, Coronary Disease, Risk Factors, Hypercholesterolemia, Hispanic Americans, Smoking, Mexico, Prevalence, Cardiovascular Diseases, Obesity, Hypertension, United States, Diabetes Mellitus


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