Elsevier

Progress in Cardiovascular Diseases

Volume 57, Issue 3, November–December 2014, Pages 253-261
Progress in Cardiovascular Diseases

Challenges in Preventing Heart Disease in Hispanics: Early Lessons Learned from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

https://doi.org/10.1016/j.pcad.2014.08.004Get rights and content

Abstract

The challenge of preventing cardiovascular disease (CVD) in US Hispanics depends upon being able to understand and communicate about the diversity within this population in terms of environmental exposures, health behaviors, socio-cultural experiences and genetic background to CVD risk factor profiles and disease burdens. Recent publications from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) launched by the National Institutes of Health (NIH) have begun to accomplish this task. In this article we review some of the HCHS/SOL findings concerning cardiometabolic and other CVD risk factors and relate them to the need for increased access to health care and attention to lifestyle variables including nutrition. A major challenge that needs to be accomplished is to alert our lawmakers, public health officials, health care providers and the Hispanic population at large about how to lighten the CVD risk factor and disease burdens now carried by our Hispanic population.

Section snippets

Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

According to the 2010 US Census, there are approximately 50.5 million Hispanics in the US, comprising about 16% of the population.7 Demographers expect that the proportion of Hispanics will grow to 30% by the year 2050.8 Although Hispanics are a diverse group in terms of sociocultural and genetic backgrounds, there is a paucity of information about Hispanic health derived from national exams and surveys. The National Health and Nutrition Examination Survey (NHANES), initiated in 1959, consists

Cardiometabolic risk factors

Various cardiometabolic risk factors have been examined in HCHS/SOL including the prevalence of: (a) DM, (b) metabolic syndrome (MetS), (c) obesity, (d) hypertension (HTN) and (e) sleep disordered breathing (SDB).

Lifestyle risk factors

During the last decade, important changes in lifestyle patterns have led to an increased prevalence of chronic conditions, including CVD and DM. In fact, the leading causes of death can be attributable to changes in lifestyle risk factors, including but not limited to: (a) smoking; and (b) poor dietary habits.

Discussion

Although Hispanics living in the US have less education, a higher poverty rate, and worse utilization and access for health care, life expectancy for Hispanics in 2006 was greater for Hispanics than for non-Hispanic whites.3 This snapshot in time may be misleading since substantial changes have occurred in recent decades in the US in terms of Hispanic population size, immigration patterns, demographics, lifestyle practices and cardiometabolic risk. The baseline visits to HCHS/SOL, conducted

Statement of Conflict of Interest

All authors declare that there are no conflicts of interest.

Acknowledgments

Supported by contracts from the National Heart, Lung, and Blood Institute (NHLBI) to the University of North Carolina (N01-HC65233), University of Miami (N01-HC65234). Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), and San Diego State University (N01-HC65237). The following Institutes/Centers/Offices contributed to the baseline HCHS/SOL funding period through a transfer of funds to the NHLBI: National Institute on Minority Health and Health

References (64)

  • O.I. Bermudez et al.

    Intake and food sources of macronutrients among older Hispanic adults: association with ethnicity, acculturation, and length of residence in the United States

    J Am Diet Assoc

    (2000)
  • J.H. Southerland et al.

    Periodontitis and diabetes associations with measures of atherosclerosis and CHD

    Atherosclerosis

    (2012)
  • A.E. Sanders et al.

    Heterogeneity in periodontitis prevalence in the Hispanic Community Health Study/Study of Latinos

    Ann Epidemiol

    (2014)
  • P. Denes et al.

    Major and minor electrocardiographic abnormalities and their association with underlying cardiovascular disease and risk factors in Hispanic/Latinos (from the Hispanic Community Health Study/Study of Latinos)

    Am J Cardiol

    (2013)
  • P. Franks et al.

    Health insurance and mortality. Evidence from a national cohort

    JAMA

    (1993)
  • E. Arias

    United States life tables by Hispanic origin

    Natl Vital Stat Rep Vital Health Stat

    (2010)
  • K.S. Markides et al.

    The health of Hispanics in the southwestern United States: an epidemiologic paradox

    Public Health Rep

    (1986)
  • H.M. Rosenberg et al.

    Quality of death rates by race and Hispanic origin: a summary of current research

    Vital Health Stat

    (1999)
  • P.D. Sorlie et al.

    Mortality by Hispanic status in the United States

    JAMA

    (1993)
  • U.S. Census Bureau Briefs

    The Hispanic population

    (2010)
  • V. Cárdenas et al.

    Progress 2050: New ideas for a diverse America

    (2011)
  • C.C. Cowie et al.

    Prevalence of diabetes and impaired fasting glucose in adults in the U.S. population: National Health and Nutrition Examination Survey 1999-2002

    Diabetes Care

    (2006)
  • C.C. Cowie et al.

    Full accounting of diabetes and pre-diabetes in the U.S. population in 1988–1994 and 2005–2006

    Diabetes Care

    (2009)
  • J.L. Delgado et al.

    Hispanic Health and Nutrition Examination Survey: methodological considerations

    Am J Public Health

    (1990)
  • J. Aponte

    Diabetes risk factors in Mexican Americans with diabetes

    Medsurg Nurs

    (2009)
  • K.M. Flegal et al.

    Prevalence of diabetes in Mexican Americans, Cubans, and Puerto Ricans from the Hispanic Health and Nutrition Examination Survey, 1982-1984

    Diabetes Care

    (1991)
  • A. Brown et al.

    Mapping the Latino population, by state, county and city. Pew Research Center Report

    (2013)
  • N. Sarwar et al.

    Diabetes mellitus, fasting blood glucose concentration, and risk of vascular disease: a collaborative meta-analysis of 102 prospective studies

    Lancet

    (2010)
  • L.S. Geiss et al.

    National Diabetes Data Group Diabetes in America

    (1995)
  • M.L. Daviglus et al.

    Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States

    JAMA

    (2012)
  • N. Schneiderman et al.

    Prevalence of diabetes among Hispanics/Latinos from diverse backgrounds: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

    Diabetes Care

    (2014)
  • Centers for Disease Control and Prevention

    National Diabetes Fact Sheet: National estimates and general information on diabetes and prediabetes in the United States

    (2011)
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    Statement of Conflict of Interest: see page 260.

    The contents of this article are solely the responsibility of the authors and do not necessarily represent the official position of the National Institutes of Health, the U.S. Department of Health and Human Services or the federal government.

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