Skip to main content

Heterogeneity, Nativity, and Disaggregation of Cardiovascular Risk and Outcomes in Hispanic Americans

  • Chapter
  • First Online:
Cardiovascular Disease in Racial and Ethnic Minority Populations

Part of the book series: Contemporary Cardiology ((CONCARD))

  • 376 Accesses

Abstract

Hispanic Americans currently comprise the largest and fastest growing minority groups in the United States . Although specific risks, prevalence, and outcomes across groups and subgroups of Hispanics living in the United States vary, cardiovascular disease (CVD) is considered the leading cause of death among this growing population. Nonetheless, when studied in aggregate, Hispanics experience better CV outcomes than non-Hispanic individuals. The rationale for this observation has been supported by several theories including a healthy Hispanic immigrant effect, duration of residence in the United States and acculturation, socioeconomic status (SES), as well as health behaviors and genetic, geographic, and psychosocial baseline characteristics; however, the exact underlying mechanism remains unknown. There remains a knowledge gap on CVD outcomes disaggregated by Hispanic ethnic background and acculturation. Unpacking the diversity within Hispanic individuals and understanding unique contributors to increased CVD risk is important to develop targeted CVD preventive efforts and therapies.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 89.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 119.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD 169.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  1. Daviglus ML, Pirzada A, Talavera GA. Cardiovascular disease risk factors in the Hispanic/Latino population: lessons from the Hispanic community health study/study of Latinos (HCHS/SOL). Prog Cardiovasc Dis. 2014;57(3):230–6.

    Article  PubMed  Google Scholar 

  2. Lopez-Jimenez F, Lavie CJ. Hispanics and cardiovascular health and the "Hispanic paradox": what is known and what needs to be discovered? Prog Cardiovasc Dis. 2014;57(3):227–9.

    Article  PubMed  Google Scholar 

  3. Rodriguez F, Hastings KG, Hu J, Lopez L, Cullen M, Harrington RA, et al. Nativity status and cardiovascular disease mortality among Hispanic adults. J Am Heart Assoc. 2017;6(12):e007207.

    Article  PubMed  PubMed Central  Google Scholar 

  4. Bureau USC. Hispanic Origin 2018. Available from: https://www.census.gov/topics/population/hispanic-origin/about.html

  5. Cohn DV. Census History: Counting Hispanics 2010. Available from: https://www.pewsocialtrends.org/2010/03/03/census-history-counting-hispanics-2/

  6. M Lopez JK, JS Passel. Who is Hispanic? 2019. Available from: https://www.pewresearch.org/fact-tank/2019/11/11/who-is-hispanic/

  7. Bureau USC. Quick Facts, Hispanic or Latino 2018. Available from: https://www.census.gov/quickfacts/fact/table/US/RHI725217

  8. Rodriguez CJ, Allison M, Daviglus ML, Isasi CR, Keller C, Leira EC, et al. Status of cardiovascular disease and stroke in Hispanics/Latinos in the United States: a science advisory from the American Heart Association. Circulation. 2014;130(7):593–625.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Statista. Hispanic population groups in the United States, by country of origin 2017 2018. Updated Apr 29 2019. Available from: https://www.statista.com/statistics/234852/us-hispanic-population/

  10. Bureau UC. Hispanic Heritage Month 2018 2018. Updated Sept 13 2019. Available from: https://www.census.gov/newsroom/facts-for-features/2018/hispanic-heritage-month.html

  11. Morales LS, Lara M, Kington RS, Valdez RO, Escarce JJ. Socioeconomic, cultural, and behavioral factors affecting Hispanic health outcomes. J Health Care Poor Underserved. 2002;13(4):477–503.

    Article  PubMed  PubMed Central  Google Scholar 

  12. Conomos MP, Laurie CA, Stilp AM, Gogarten SM, McHugh CP, Nelson SC, et al. Genetic diversity and association studies in US Hispanic/Latino populations: applications in the Hispanic community health study/study of Latinos. Am J Hum Genet. 2016;98(1):165–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  13. Markides KS, Coreil J. The health of Hispanics in the southwestern United States: an epidemiologic paradox. Public Health Rep (Washington, DC: 1974). 1986;101(3):253–65.

    CAS  Google Scholar 

  14. Hunt KJ, Williams K, Resendez RG, Hazuda HP, Haffner SM, Stern MP. All-cause and cardiovascular mortality among diabetic participants in the San Antonio heart study: evidence against the “Hispanic paradox”. Diabetes Care. 2002;25(9):1557–63.

    Article  PubMed  Google Scholar 

  15. Marks G, Garcia M, Solis JM. Health risk behaviors of Hispanics in the United States: findings from HHANES, 1982-84. Am J Public Health. 1990;80(Suppl):20–6.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Greer S, Kramer MR, Cook-Smith JN, Casper ML. Metropolitan racial residential segregation and cardiovascular mortality: exploring pathways. J Urban Health Bull N Y Acad Med. 2014;91(3):499–509.

    Article  Google Scholar 

  17. Kershaw KN, Diez Roux AV, Burgard SA, Lisabeth LD, Mujahid MS, Schulz AJ. Metropolitan-level racial residential segregation and black-white disparities in hypertension. Am J Epidemiol. 2011;174(5):537–45.

    Article  PubMed  PubMed Central  Google Scholar 

  18. Do DP, Frank R, Zheng C, Iceland J. Hispanic segregation and poor health: it’s not just black and white. Am J Epidemiol. 2017;186(8):990–9.

    Article  PubMed  Google Scholar 

  19. Subramanian SV, Acevedo-Garcia D, Osypuk TL. Racial residential segregation and geographic heterogeneity in black/white disparity in poor self-rated health in the US: a multilevel statistical analysis. Soc Sci Med. 2005;60(8):1667–79.

    Article  CAS  PubMed  Google Scholar 

  20. Jackson SA, Anderson RT, Johnson NJ, Sorlie PD. The relation of residential segregation to all-cause mortality: a study in black and white. Am J Public Health. 2000;90(4):615–7.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  21. Kramer MR, Hogue CR. Place matters: variation in the black/white very preterm birth rate across U.S. metropolitan areas, 2002-2004. Public Health Rep (Washington, DC: 1974). 2008;123(5):576–85.

    Article  Google Scholar 

  22. Osypuk TL, Diez Roux AV, Hadley C, Kandula NR. Are immigrant enclaves healthy places to live? The multi-ethnic study of atherosclerosis. Soc Sci Med. 2009;69(1):110–20.

    Article  PubMed  PubMed Central  Google Scholar 

  23. Kershaw KN, Osypuk TL, Do DP, De Chavez PJ, Diez Roux AV. Neighborhood-level racial/ethnic residential segregation and incident cardiovascular disease: the multi-ethnic study of atherosclerosis. Circulation. 2015;131(2):141–8.

    Article  PubMed  Google Scholar 

  24. Li K, Wen M, Henry KA. Ethnic density, immigrant enclaves, and Latino health risks: a propensity score matching approach. Soc Sci Med. 2017;189:44–52.

    Article  PubMed  PubMed Central  Google Scholar 

  25. Eschbach K, Ostir GV, Patel KV, Markides KS, Goodwin JS. Neighborhood context and mortality among older Mexican Americans: is there a barrio advantage? Am J Public Health. 2004;94(10):1807–12.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Rodriguez F, Hu J, Kershaw K, Hastings KG, Lopez L, Cullen MR, et al. County-level Hispanic ethnic density and cardiovascular disease mortality. J Am Heart Assoc. 2018;7(19):e009107.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Dominguez K, Penman-Aguilar A, Chang MH, Moonesinghe R, Castellanos T, Rodriguez-Lainz A, et al. Vital signs: leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States - 2009-2013. MMWR Morb Mortal Wkly Rep. 2015;64(17):469–78.

    PubMed  PubMed Central  Google Scholar 

  28. Alegria M. The challenge of acculturation measures: what are we missing? A commentary on Thomson & Hoffman-Goetz. Soc Sci Med. 2009;69(7):996–8.

    Article  PubMed  PubMed Central  Google Scholar 

  29. Shaw PM, Chandra V, Escobar GA, Robbins N, Rowe V, Macsata R. Controversies and evidence for cardiovascular disease in the diverse Hispanic population. J Vasc Surg. 2018;67(3):960–9.

    Article  PubMed  Google Scholar 

  30. Winkleby MA, Jatulis DE, Frank E, Fortmann SP. Socioeconomic status and health: how education, income, and occupation contribute to risk factors for cardiovascular disease. Am J Public Health. 1992;82(6):816–20.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Rodriguez F, Leonard D, DeFina L, Barlow CE, Willis BL, Haskell WL, et al. Association of educational attainment and cardiovascular risk in Hispanic individuals: findings from the Cooper Center longitudinal study. JAMA Cardiol. 2019;4(1):43–50.

    Article  PubMed  PubMed Central  Google Scholar 

  32. Lutsey PL, Diez Roux AV, Jacobs DR Jr, Burke GL, Harman J, Shea S, et al. Associations of acculturation and socioeconomic status with subclinical cardiovascular disease in the multi-ethnic study of atherosclerosis. Am J Public Health. 2008;98(11):1963–70.

    Article  PubMed  PubMed Central  Google Scholar 

  33. Koya DL, Egede LE. Association between length of residence and cardiovascular disease risk factors among an ethnically diverse group of United States immigrants. J Gen Intern Med. 2007;22(6):841–6.

    Article  PubMed  PubMed Central  Google Scholar 

  34. Adler NE, Ostrove JM. Socioeconomic status and health: what we know and what we don’t. Ann N Y Acad Sci. 1999;896:3–15.

    Article  CAS  PubMed  Google Scholar 

  35. Kimbro RT, Bzostek S, Goldman N, Rodriguez G. Race, ethnicity, and the education gradient in health. Health Affairs (Project Hope). 2008;27(2):361–72.

    Article  Google Scholar 

  36. Sorlie PD, Backlund E, Keller JB. US mortality by economic, demographic, and social characteristics: the National Longitudinal Mortality Study. Am J Public Health. 1995;85(7):949–56.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  37. Prevention CfDCa. National Health and Nutrition Examination Survey (NHANES) 2019 [updated May 8 2019; cited 2019 2019]. Available from: https://www.cdc.gov/nchs/nhanes/index.htm

  38. Prevention CfDCa. Behavioral Risk Factor Surveillance System (BRFSS) 2019. Updated April 17, 2019. Available from: https://www.cdc.gov/nchs/nhis/index.htm

  39. Balfour PC Jr, Ruiz JM, Talavera GA, Allison MA, Rodriguez CJ. Cardiovascular disease in Hispanics/Latinos in the United States. J Lat Psychol. 2016;4(2):98–113.

    Article  PubMed  PubMed Central  Google Scholar 

  40. Study HCH. Hispanic Community Health Study/Study of Latinos, Study Overview. Available from: https://sites.cscc.unc.edu/hchs/StudyOverview

  41. Daviglus ML, Talavera GA, Aviles-Santa ML, Allison M, Cai J, Criqui MH, et al. Prevalence of major cardiovascular risk factors and cardiovascular diseases among Hispanic/Latino individuals of diverse backgrounds in the United States. JAMA. 2012;308(17):1775–84.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  42. Rodriguez CJ, Diez-Roux AV, Moran A, Jin Z, Kronmal RA, Lima J, et al. Left ventricular mass and ventricular remodeling among Hispanic subgroups compared with non-Hispanic blacks and whites: MESA (Multi-ethnic study of atherosclerosis). J Am Coll Cardiol. 2010;55(3):234–42.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Mainous AG 3rd, Majeed A, Koopman RJ, Baker R, Everett CJ, Tilley BC, et al. Acculturation and diabetes among Hispanics: evidence from the 1999-2002 National Health and nutrition examination survey. Public Health Rep (Washington, DC: 1974). 2006;121(1):60–6.

    Article  Google Scholar 

  44. Davidson JA, Kannel WB, Lopez-Candales A, Morales L, Moreno PR, Ovalle F, et al. Avoiding the looming Latino/Hispanic cardiovascular health crisis: a call to action. Ethn Dis. 2007;17(3):568–73.

    PubMed  Google Scholar 

  45. Lara M, Gamboa C, Kahramanian MI, Morales LS, Bautista DEH. Acculturation and Latino health in the United States: a review of the literature and its sociopolitical context. Annu Rev Public Health. 2005;26(1):367–97.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Derby CA, Wildman RP, McGinn AP, Green RR, Polotsky AJ, Ram KT, et al. Cardiovascular risk factor variation within a Hispanic cohort: SWAN, the Study of Women’s Health Across the Nation. Ethn Dis. 2010;20(4):396–402.

    PubMed  Google Scholar 

  47. Stone Neil J, Robinson Jennifer G, Lichtenstein Alice H, Bairey Merz CN, Blum Conrad B, Eckel Robert H, et al. 2013 ACC/AHA guideline on the treatment of blood cholesterol to reduce atherosclerotic cardiovascular risk in adults. Circulation. 2014;129(25_suppl_2):S1–S45.

    CAS  PubMed  Google Scholar 

  48. Grundy Scott M, Stone Neil J, Bailey Alison L, Beam C, Birtcher Kim K, Blumenthal Roger S, et al. 2018 AHA/ACC/AACVPR/AAPA/ABC/ACPM/ADA/AGS/APhA/ASPC/NLA/PCNA guideline on the Management of Blood Cholesterol: a report of the American College of Cardiology/American Heart Association task force on clinical practice guidelines. Circulation. 2019;139(25):e1082–e143.

    CAS  PubMed  Google Scholar 

  49. Goff David C, Lloyd-Jones Donald M, Bennett G, Coady S, D’Agostino Ralph B, Gibbons R, et al. 2013 ACC/AHA guideline on the assessment of cardiovascular risk. Circulation. 2014;129(25_suppl_2):S49–73.

    PubMed  Google Scholar 

  50. DeFilippis AP, Young R, Carrubba CJ, McEvoy JW, Budoff MJ, Blumenthal RS, et al. An analysis of calibration and discrimination among multiple cardiovascular risk scores in a modern multiethnic cohort. Ann Intern Med. 2015;162(4):266–75.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Karmali KN, Goff DC Jr, Ning H, Lloyd-Jones DM. A systematic examination of the 2013 ACC/AHA pooled cohort risk assessment tool for atherosclerotic cardiovascular disease. J Am Coll Cardiol. 2014;64(10):959–68.

    Article  PubMed  Google Scholar 

  52. Muntner P, Colantonio LD, Cushman M, Goff DC Jr, Howard G, Howard VJ, et al. Validation of the atherosclerotic cardiovascular disease pooled cohort risk equations. JAMA. 2014;311(14):1406–15.

    Article  PubMed  PubMed Central  CAS  Google Scholar 

  53. Rodriguez FCS, Blum MR, Coulet A, Basu S, Palaniappan LP. Atherosclerotic cardiovascular disease risk prediction in disaggregated Asian and Hispanic subgroups using electronic health records. J Am Heart Assoc. 2019;8(14):e011874.

    Article  PubMed  PubMed Central  Google Scholar 

  54. Benjamin Emelia J, Muntner P, Alonso A, Bittencourt Marcio S, Callaway Clifton W, Carson April P, et al. Heart disease and stroke statistics—2019 update: a report from the American Heart Association. Circulation. 2019;139(10):e56–e528.

    CAS  PubMed  Google Scholar 

  55. Rodriguez F, Hastings KG, Boothroyd DB, Echeverria S, Lopez L, Cullen M, et al. Disaggregation of cause-specific cardiovascular disease mortality among Hispanic subgroups. JAMA Cardiol. 2017;2(3):240–7.

    Article  PubMed  PubMed Central  Google Scholar 

  56. Wunnemann F, Sin Lo K, Langford-Avelar A, Busseuil D, Dube MP, Tardif JC, et al. Validation of genome-wide polygenic risk scores for coronary artery disease in French Canadians. Circulation Genomic Precision Med. 2019;12(6):e002481.

    Article  Google Scholar 

  57. Martin AR, Kanai M, Kamatani Y, Okada Y, Neale BM, Daly MJ. Clinical use of current polygenic risk scores may exacerbate health disparities. Nat Genet. 2019;51(4):584–91.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  58. Grinde KE, Qi Q, Thornton TA, Liu S, Shadyab AH, Chan KHK, et al. Generalizing polygenic risk scores from Europeans to Hispanics/Latinos. Genet Epidemiol. 2019;43(1):50–62.

    Article  PubMed  Google Scholar 

  59. Manichaikul A, Palmas W, Rodriguez CJ, Peralta CA, Divers J, Guo X, et al. Population structure of Hispanics in the United States: the multi-ethnic study of atherosclerosis. PLoS Genet. 2012;8(4):e1002640-e.

    Article  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Fatima Rodriguez .

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 2021 Springer Nature Switzerland AG

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Blumer, V., Rodriguez, F. (2021). Heterogeneity, Nativity, and Disaggregation of Cardiovascular Risk and Outcomes in Hispanic Americans. In: Ferdinand, K.C., Taylor, Jr., H.A., Rodriguez, C.J. (eds) Cardiovascular Disease in Racial and Ethnic Minority Populations. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-030-81034-4_8

Download citation

  • DOI: https://doi.org/10.1007/978-3-030-81034-4_8

  • Published:

  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-81033-7

  • Online ISBN: 978-3-030-81034-4

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics