Hispanic Women Have Heart Disease Risks at Earlier Age
Hispanic women develop cardiac risk factors much earlier than Caucasian women, typically exhibiting the heart health status of a Caucasian woman 10 years older, according to a report from a recent Cardiovascular Disease Epidemiology and Prevention conference, sponsored by the American Heart Association.
The research suggests that being Hispanic may be an independent risk factor for heart disease, and that these women need to be identified and treated earlier.
"The tendency for medical practice is to assume that Hispanics have a delayed onset or less prevalence of cardiac disease, and our study shows that they have earlier onset and the same risk as Caucasians," says study author Dr. John Teeters, a cardiology fellow at the University of Rochester Medical Center.
"Physicians should be more aggressively targeting this population for identification of risk factors such as cholesterol and obesity and recognizing that a 20- or 30-year-old Hispanic may have the same risk factors as a 30- or 40-year-old Caucasian," he says.
The findings turn the so-called "Hispanic Paradox" on its head. This medical notion has long held that Hispanics have less heart disease than Caucasians do, despite having higher rates of risk factors.
But Dr. Teeters and his colleagues found that Hispanic women have earlier onset of disease, more risk factors, and an equal, if not higher, risk of cardiac disease.
"We did the study because the literature shows that the risk is less,” he says. “But, in actual clinical practice, Hispanic patients are coming in with a lot of risk factors.”
In other words, there appeared to be a wide gap between theory and practice.
For this study, the researchers conducted a series of free community health screenings at churches, community centers, and outpatient clinics that primarily serve Hispanics.
Medical histories were collected for 79 Hispanic women, along with measurements of blood pressure, body mass index (BMI), waist circumference, lipid profiles, and blood sugar.
A group of 91 Caucasian women were compared. The average age of the Hispanic women was 53 versus 63 in the Caucasian group. Only 61 percent of the Hispanic women were postmenopausal, compared with 85 percent of the Caucasian women.
Despite age differences and differences in menopausal status, heart disease risk for the two ethnic groups was about the same.
Hispanic women had a higher rate of pre-hypertension (32 percent) compared with Caucasian women (19 percent).
Physical activity levels for Hispanic women were significantly lower and they had a slightly higher rate of metabolic syndrome, a cluster of risk factors that predispose a person towards cardiovascular disease.
Scores for hypertension, diabetes, high cholesterol, and waist circumference were similar between the two groups.
"I thought the findings were shocking," says Dr. Suzanne Steinbaum, director of women and heart disease and the Heart and Vascular Institute at Lenox Hill Hospital in New York City. "We have to find out what about Hispanic women is leading to this increased risk of heart disease."
"Hispanic women need to get checked earlier because their risk is earlier," adds Dr. Steinbaum. "Hispanic women in their 20s really need to have an exam. Pre-hypertension needs to be looked for and treated early."
What, then, explains the wide acceptance among clinicians of the Hispanic Paradox?
Dr. Teeters believes that the Hispanic Paradox may have resulted from incomplete data.
"Hispanic patients are less likely to come to care, so there's probably under-recognition of the degree of disease," notes Dr. Teeters.
"Many are immigrants and many go home when they become ill. There's also a higher degree of illegal alien status so there's probably underreporting," says Dr. Teeters.
Always consult your physician for more information.
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The National Heart, Lung, and Blood Institute (NHLBI) says that some risk factors, such as age (55 or older for women) and a family history of early heart disease, cannot be changed.
Women can, however, control certain risk factors, such as high blood pressure, high blood cholesterol, diabetes, smoking, being overweight or obese, and being physically inactive.
For midlife women, the most common risk factors for heart disease in order of greatest prevalence include, overweight/obesity, high blood cholesterol, and high blood pressure.
The NHLBI states that African-American and Hispanic women, in particular, have higher rates of some risk factors for heart disease and are disproportionately affected by the disease.
More than 80 percent of midlife African-American women are overweight or obese, 52 percent have hypertension, and 14 percent have been diagnosed with diabetes.
Some 83 percent of midlife Hispanic women are overweight or obese, and more than 10 percent have been diagnosed with diabetes.
Recently, the NHLBI took its Heart Truth campaign directly to women of color.
The Heart Truth has formed partnerships with leading national organizations representing women of color to sound a red alert about the nation's number one killer of women.
Together with its partners, the campaign has engaged in national and local activities to help more women of color understand The Heart Truth and inspire them to take action to reduce their risk for heart disease.
Since the launch of The Heart Truth's Women of Color initiative in 2005, the campaign and its messages have reached thousands of African-American and Hispanic women throughout the US.
Through workshops, faith-based initiatives, special events, newsletters, Web sites, and public service announcements (PSAs), The Heart Truth's Women of Color partners have spread the word and encouraged their members and constituents to take action.
Always consult your physician for more information.
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