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Multicenter Study
. 2012 Nov 7;308(17):1775-84.
doi: 10.1001/jama.2012.14517.

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

Martha L Daviglus  1 , Gregory A Talavera, M Larissa Avilés-Santa, Matthew Allison, Jianwen Cai, Michael H Criqui, Marc Gellman, Aida L Giachello, Natalia Gouskova, Robert C Kaplan, Lisa LaVange, Frank Penedo, Krista Perreira, Amber Pirzada, Neil Schneiderman, Sylvia Wassertheil-Smoller, Paul D Sorlie, Jeremiah Stamler
Affiliations
Multicenter Study

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

Martha L Daviglus et al. JAMA. .

Abstract

Context: Major cardiovascular diseases (CVDs) are leading causes of mortality among US Hispanic and Latino individuals. Comprehensive data are limited regarding the prevalence of CVD risk factors in this population and relations of these traits to socioeconomic status (SES) and acculturation.

Objectives: To describe prevalence of major CVD risk factors and CVD (coronary heart disease [CHD] and stroke) among US Hispanic/Latino individuals of different backgrounds, examine relationships of SES and acculturation with CVD risk profiles and CVD, and assess cross-sectional associations of CVD risk factors with CVD.

Design, setting, and participants: Multicenter, prospective, population-based Hispanic Community Health Study/Study of Latinos including individuals of Cuban (n = 2201), Dominican (n = 1400), Mexican (n = 6232), Puerto Rican (n = 2590), Central American (n = 1634), and South American backgrounds (n = 1022) aged 18 to 74 years. Analyses involved 15,079 participants with complete data enrolled between March 2008 and June 2011.

Main outcome measures: Adverse CVD risk factors defined using national guidelines for hypercholesterolemia, hypertension, obesity, diabetes, and smoking. Prevalence of CHD and stroke were ascertained from self-reported data.

Results: Age-standardized prevalence of CVD risk factors varied by Hispanic/Latino background; obesity and current smoking rates were highest among Puerto Rican participants (for men, 40.9% and 34.7%; for women, 51.4% and 31.7%, respectively); hypercholesterolemia prevalence was highest among Central American men (54.9%) and Puerto Rican women (41.0%). Large proportions of participants (80% of men, 71% of women) had at least 1 risk factor. Age- and sex-adjusted prevalence of 3 or more risk factors was highest in Puerto Rican participants (25.0%) and significantly higher (P < .001) among participants with less education (16.1%), those who were US-born (18.5%), those who had lived in the United States 10 years or longer (15.7%), and those who preferred English (17.9%). Overall, self-reported CHD and stroke prevalence were low (4.2% and 2.0% in men; 2.4% and 1.2% in women, respectively). In multivariate-adjusted models, hypertension and smoking were directly associated with CHD in both sexes as were hypercholesterolemia and obesity in women and diabetes in men (odds ratios [ORs], 1.5-2.2). For stroke, associations were positive with hypertension in both sexes, diabetes in men, and smoking in women (ORs, 1.7-2.6).

Conclusion: Among US Hispanic/Latino adults of diverse backgrounds, a sizeable proportion of men and women had adverse major risk factors; prevalence of adverse CVD risk profiles was higher among participants with Puerto Rican background, lower SES, and higher levels of acculturation.

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Conflict of interest statement

Conflict of Interest Disclosures: All authors have completed and submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest. Dr Cai reported having consulted for Outcomes Research Solutions. Dr Gellman reported receiving book royalties from Springer. No other disclosures were reported.

Figures

Figure 1
Figure 1. Prevalence of Adverse Cardiovascular Disease Risk Profiles for All Participants and by Hispanic/Latino Group and Sex
Risk factors were hypercholesterolemia (serum total cholesterol ≥240 mg/dL or taking cholesterol-lowering medication), hypertension (systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or taking antihypertensive medication), obesity (body mass index ≥30, calculated as weight in kilograms divided by height in meters squared), diabetes mellitus (use of diabetes medication, fasting glucose ≥126 mg/dL, 2-hour-postload plasma glucose ≥200 mg/dL, or hemoglobin A1c ≥6.5%), and smoking (current cigarette smoker). Values were weighted for survey design and nonresponse and adjusted for age. Error bars indicate 95% CI.
Figure 2
Figure 2. Association of Cardiovascular Disease Risk Factors With Cardiovascular Disease Prevalence Among Hispanic/Latino Participants by Sex
High cholesterol was defined as serum total cholesterol level ≥240 mg/dL or taking cholesterol-lowering medication. High blood pressure was defined as systolic blood pressure ≥140 mm Hg or diastolic blood pressure ≥90 mm Hg or taking antihypertensive medication. Obesity was defined as a body mass index ≥30 (calculated as weight in kilograms divided by height in meters squared). Diabetes mellitus was defined as use of diabetes medication, fasting glucose ≥126 mg/dL, 2-hour-postload plasma glucose ≥200 mg/dL, or hemoglobin A1c ≥6.5%. Smoking was defined as current cigarette smoker. Model 1 was adjusted for age. Model 2 was adjusted for age and all other major biomedical cardiovascular disease risk factors. Model 3 was adjusted for all variables in model 2 plus education, annual family income, Hispanic/ Latino background, language preference, nativity (US born), Short Acculturation Scale for Hispanics score, physical activity, and diet. Error bars indicate 95% CI.
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