Cardiovascular Epidemiology in Hispanics/Latinos: Lessons Learned from HCHS/SOL

Abstract

Hispanics constitute the largest growing ethnic group in the United States (US). They are disproportionately affected by cardiovascular (CV) risk factors and despite accounting for a large sector of the population, as the largest ethnic minority in the US, until recently they were unaccounted for in clinical guidelines and public health policies. Hispanics are a heterogeneous group whose members come from different countries of mixed racial backgrounds (with some generalizations, Caucasian in South America, Amerindian in Central America and Mexico, and African in the Caribbean); they carry different histories, societal structures, and geography. In spite of a high degree of first-generation migrants, Hispanics hold a common identity in the U.S. that somehow blurs the race vs. ethnic divide.

The Hispanic Communities Health Study-Study of Latinos (HCHS/SOL) constitutes the largest study focused on CV risks of Hispanics. Prior descriptions of their profile were biased towards specific origins or had significant under-representation. Notably, this group carries a high burden of risk and socioeconomic disparity but has lower rates of CV disease, a phenomena known as Hispanic Paradox. Yet, grouping all Hispanics gives risk to fallacy as HCHS/SOL has uncovered their disparate socio-demographic profiles, adverse nutritional and exercise habits, lifestyles, cardio-metabolic risk factors, medication use, anthropomorphic phenotypes amongst other factors.

This chapter will summarize HCHS/SOL results contextualizing them in respect to the AHA Science Advisory document on the status of CV disease and Stroke in Hispanics. The comments included here will provide insight in this era of precision medicine of the need for inclusive, socially conscious, and culturally sensitive interventions that relate to Hispanics living in the U.S.