By AMERICAN HEART ASSOCIATION NEWS
Heart disease and stroke researchers say the writing is on the wall for young Hispanic-Americans. If worrisome health trends continue, they may be sicker than their parents and grandparents when they reach that age — or perhaps sooner.
Hispanic-American adults of any race have among the highest rates of obesity, uncontrolled high blood pressure, uncontrolled diabetes and high cholesterol — all risk factors for heart disease and stroke. Hispanic-American children have among the highest obesity rates, and are more likely to have Type 2 diabetes than white children.
Considering that 42 million Hispanics and Latinos are younger than 45, the long-term health implications are dire.
“We can expect a substantial increase in the number of Hispanic people that suffer from heart disease and stroke if we don’t pay attention and take care of the problem,” said Salvador Cruz-Flores, M.D., chair of neurology at the Paul L. Foster School of Medicine at Texas Tech University Health Sciences Center in El Paso.
There are more than 57 million Hispanic-Americans, according to the latest estimates from the U.S. Census Bureau, making them the country’s largest ethnic population. The under-45 age group represents almost three-quarters of that demographic — a substantially higher proportion than their black and white peers.
“In the vast majority of cases, we can make a difference in reversing the trend of poor health — but we have to start early,” said Carlos J. Rodriguez, M.D., a professor of medicine and public health sciences at Wake Forest School of Medicine.
Experts say it has been difficult to estimate heart disease and stroke risk in Hispanics because there isn’t enough long-term health data. Plus, the many ethnic subgroups and socioeconomic differences among them and within them makes it hard to adequately study diseases in those populations.
Cardiologist Enrique García-Sayán, M.D., said even a popular tool used by cardiologists to assess a person’s risk of heart disease or stroke can’t be relied upon for Hispanic patients because it was developed using data from whites and African-Americans and may miscalculate risk for Hispanic-Americans. And patients shouldn’t be misled by CDC data that show Hispanic-Americans live at least three years longer than black and white Americans.
“The bottom line is, we should not underestimate the importance of heart disease in Hispanics,” said García-Sayán, an assistant professor of cardiovascular medicine at UT Health Sciences Center in Houston.
One study that is providing some insights is the Hispanic Community Health Study/Study of Latinos, also known as SOL.
Some of the most important data from the decade-old study show heart disease and stroke risk factors affect Hispanic ethnic groups differently, said Rodriguez, lead author of a 2014 American Heart Association advisory on heart disease and stroke in U.S. Hispanics.
For instance, a 2014 study using data from SOL showed diabetes was more prevalent in Mexican-Americans — the largest ethnic subpopulation of U.S. Hispanics — and Puerto Ricans than South Americans. A separate study found obesity was most common among Puerto Ricans and less common among South Americans, while another found high blood pressure is more common among Dominicans and Puerto Ricans than other Hispanic ethnic groups.
Among Hispanic adults, Rodriguez said a preliminary unpublished analysis from a SOL ancillary project suggests they have a higher burden of high blood pressure, diabetes, obesity and other conditions that may lead to heart disease and stroke compared with their white and black counterparts.
Risk factors tend to be more common among young Hispanic men than women, according to a 2013 report of SOL data. For example, men ages 18 to 44 are more likely to smoke, have high cholesterol and be prediabetic compared to Hispanic women of the same age.
Having access to preventive care is critical to stave off or manage heart disease and stroke risk factors among the young Hispanic community, experts say.
Because Hispanics tend to earn less than other Americans and have a high rate of uninsured adults, the public and private sectors should do more to make basic care more affordable to low-income Americans, Cruz-Flores said.
But everyone must play their role, he said, pointing out that federal, state and local health departments and health groups must continue campaigns to educate people about the risks and consequences of heart disease and stroke. And primary care doctors should take the time to learn more about patients’ economic situation, which impacts the quality of their diet and what medications they can afford, he said.
But ultimately, García-Sayán said, patients must take responsibility for their health.
“I shouldn’t be seeing people in their 30s [with cardiovascular diseases],” he said. “The rates of obesity and diabetes and hypertension that we’re seeing are in part a direct result of a poor lifestyle in this community.”
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