Among Hispanic women living in the U.S., 37% are affected by cardiovascular disease and it is the primary cause of death, according to a JACC Review Topic of the Week published April 22.

Odayme Quesada, MD, FACC, et al., write in their review that Hispanic women have a higher burden of cardiovascular risk factors and "are disproportionally affected" by social determinants of health (SDOH), and that recent studies challenge the so-called Hispanic paradox which suggested they had lower rates of cardiovascular disease and mortality than non-Hispanic White women. The authors provide an overview of this new research that takes into account the diversity in culture, race, genetic background, country of origin and SDOH within Hispanic populations.

Additionally, they provide a comprehensive review of cardiovascular health in Hispanic women living in the U.S., including traditional and emerging risk factors; maternal cardiovascular disease morbidity and mortality; and cardiovascular disease and cardiovascular disease mortality. The review delves into the impact of SDOH, including immigrant status differences by country of origin; acculturation; race and discrimination; health literacy and language; as well as education, economic stability, rurality and access to care, along with cultural values, social support and the importance of "familismo," which emphasizes the importance of family support.

The review also highlights current gaps in knowledge. "Addressing these gaps necessitates coordinated action across key areas," write the authors. They discuss a number of efforts that together "can create a holistic approach to mitigate [cardiovascular disease] risk in Hispanic women," involving national health policy, health care systems, professional societies and community-based organizations, and health care practitioners. They also provide a framework for achieving equitable care in Hispanic women.