Hispanic women's heart disease risk is comparable to the heart disease risk level of Caucasian women who are about a decade older. This disagrees with a long-held belief that Hispanic women have less heart disease than Caucasian women, researchers reported today at the American Heart Association's 47th Annual Conference on Cardiovascular Disease Epidemiology and Prevention.
"The prevailing theme in medicine has been that Hispanic patients have fewer heart attacks and strokes than Caucasians, even though Hispanics seem to have equal, if not worse, cardiac risk factors and tend to be more socio-economically deprived," said John C. Teeters, M.D., study lead author and fellow in the department of cardiology, University of Rochester, Rochester, NY. "In clinical practice, however, we see the opposite, with Hispanic patients who seem to have heart disease earlier than Caucasians."
To explain the disparity, researchers have raised questions about the quality of Hispanic population census gathering in the United States, wondering if Hispanics are underrepresented in the census and health records because they tend to migrate back to their homelands to die and are more likely to be illegal immigrants.
To compare heart disease risk among the ethnic populations, Teeters and colleagues conducted a series of free community health screenings at churches, community centers and outpatient clinics that cater to Hispanics. They performed medical histories to determine cardiac risk, as well as measured each subject's waist circumference, activity level, weight, height, blood pressure, blood sugar and cholesterol level. They gathered the same data in a Caucasian group of people and compared data among the women in the study.
There were 79 Hispanic and 91 Caucasian adult women in the study. The average age in the Hispanic group was 53, versus 63 years in the Caucasian group. Sixty-one percent of the Hispanic women were postmenopausal versus 85 percent of the Caucasian women.
When combined, the heart disease risk for the two groups was about the same, according to Teeters.
"If you look at prevalence by age, there is a clear trend for Hispanics towards increased prevalence at a younger age, with earlier onset in Hispanic women for these cardiac risk factors," he said.
While the women scored similarly in the areas of hypertension, diabetes, high cholesterol and waist circumference, the researchers found that the Hispanic women's prehypertension rate (32 percent) was significantly higher than Caucasian women (19 percent). The Hispanic women's activity levels were also significantly lower when compared to the Caucasian women, and Hispanic women had a slightly higher rate of metabolic syndrome.
Metabolic syndrome is a cluster of cardiovascular disease and diabetes risk factors including excess waist circumference, high blood pressure, elevated triglycerides, low levels of high-density lipoprotein (HDL) and high fasting glucose levels. The presence of three or more of the factors increases a person's risk of developing diabetes and cardiovascular disease.
"The study suggests that Hispanic women develop cardiac risk factors earlier than their Caucasian counterparts and that being Hispanic could be an independent risk factor for heart disease among women," Teeters said.
Doctors should consider more aggressively treating and trying to prevent heart disease at earlier ages, Teeter said. Teeters and colleagues plan to study these patients prospectively to determine if early and aggressive heart disease therapy and lifestyle changes reduce Hispanics' lifetime cardiac risk.
Co-authors are Gladys P. Velarde, M.D.; Jason Pacos, M.D.; Susan Hume, N.P.; Cynthia Petit, R.N., B.S.N. and Jeff Huntress, Pharm.D.
Outreach clinics were funded by Pfizer Inc.; however, Pfizer did not fund data analysis or have any input into presentation of the data.
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