HCHS/SOL Cohort Study Provides Crucial Insights into CVD in Hispanic/Latino Populations

The multicenter Hispanic Community Health Study/Study of Latinos (HCHS/SOL), initiated by the National Heart, Lung, and Blood Institute in 2006, is the largest and most comprehensive, longitudinal community-based cohort study to date of diverse Hispanic/Latino persons in the U.S. Current findings from the main study and from some of the numerous ancillary studies, along with a description of the aims/objectives of the study, were published April 10 in JACC.

The landmark study was designed to address the lack of comprehensive data on risk factors for cardiovascular disease and other chronic diseases in these populations and to identify the prevalence of and risk/protective factors for cardiovascular disease and pulmonary disease in diverse Hispanic/Latino populations living in the U.S. It also aimed to determine the role of acculturation in the prevalence and development of risk factors and to quantify all-cause mortality and fatal and nonfatal cardiovascular disease.

Amber Pirzada, MD, et al., note that HCHS/SOL has made “critical and sizable contributions” to understanding the prevalence and risk factors and the burden of cardiovascular disease among adults of diverse Hispanic/Latin backgrounds in the U.S., including:

  1. The data illustrate a sizable burden of major cardiovascular disease risk factors overall and variation in the prevalence of risk factors in persons with Hispanic/Latino backgrounds. The study revealed that about 80% of men and 71% of women had at least one adverse major risk factor for cardiovascular disease; the prevalence of 3+ adverse risk factors was highest among men and women of Puerto Rican background and lowest among those of South American background.

  2. There was a higher probability of hypertension (21.7% for men and 19.7% for women), which varied by Hispanic/Latino background. With an age-adjusted incidence, diabetes was 22.1 per 1,000 person-years and was higher among persons of Puerto Rican and Mexican backgrounds, adults ages ≥45 years, and those who were obese.

  3. The prevalence of risk factors was significantly higher among participants with less education (16.1%), those born in the U.S. (18.5%) and those living in the U.S. ≥10 years (15.7%).

  4. The ECHO-SOL substudy has been instrumental in providing normal reference values for cardiac structure specific to Hispanic/Latino patients, and demonstrated that a considerable segment of this population living in the U.S. may be classified as having abnormal measures of cardiac chambers when using the cutoffs from the American Society of Echocardiography.

The study is also examining the influence of genetics within Hispanic/Latino populations on blood pressure, diabetes, heart rhythm, sleep apnea and pulmonary function, and how the environment may modify and potentially explain differences in risk factors and outcomes between population groups.

The authors write: “The continued follow-up of this cohort and accrual of events over time will allow in-depth investigations to identify specific risk and protective factors associated with cardiovascular and pulmonary outcomes in men and women of diverse Hispanic/Latino backgrounds, and data from the ongoing ancillary studies will facilitate both detailed investigations of specific aspects of the health of this population and the generation of new hypotheses and study questions.”

In an accompanying editorial comment, Fatima Rodriguez, MD, MPH, FACC, and Vanessa Blumer, MD, note that the HCHS/SOL “provide ample opportunities for ancillary studies by leveraging interinstitutional and international partnerships and publicizing the potential for these collaborations” that allows for more extensive and more profound research to be conducted to improve the representation of diverse groups in clinical trials.

Keywords: Chronic Disease, Obesity, Lung Diseases, Heart Disease Risk Factors, Diabetes Mellitus, Risk Factors, Reference Values, Follow-Up Studies, Apnea, Protective Factors, Incidence, Cohort Studies, Amber, Prevalence, Cardiovascular Diseases, Acculturation, Middle Aged

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