Healthcare providers need to consider culture and ethnicity as they council Hispanic patients on health behavior and health outcomes. Because Hispanics are the largest and fastest growing ethnic population in the United States, new research and clinical efforts should be directed towards understanding their range of diverse racial and cultural profiles. Addressing the cardiovascular health of U.S. minority populations, such as Hispanics, will help improve the cardiovascular health of the country as a whole.
A first-time comprehensive overview of cardiovascular disease among Hispanics in the U.S. outlines the burden of heart disease and stroke as well as emphasizes the importance of culturally appropriate healthcare for this population.
The American Heart Association scientific statement is published in the Association's journal Circulation.
Hispanics represent the fastest-growing racial or ethnic population in the United States and are expected to constitute 30 percent of the total U.S. population by the year 2050. Yet, there is no comprehensive document about the cultural values and behavioral aspects that influence cardiovascular health promotion, prevention, and acceptance of treatment recommendations among Hispanics.
"This segment of the population has been somewhat ignored," said Carlos Rodriguez, M.D., M.P.H., lead statement author and chair of the writing group and an associate professor of medicine and epidemiology at Wake Forest Baptist Medical Center in Winston-Salem, N.C. "Given the large Hispanic population in the U.S., it would be very hard to improve the health of the nation if this population is left behind."
Heart disease is the No. 1 cause of death for Hispanics, just as it is for the rest of the population, but multiple surveys show that Hispanics are much less aware of this danger - and their own personal risk factors - than non-Hispanic whites. The new statement highlights research showing key differences in the cardiovascular health of Hispanics, including:
- Hispanics are twice as likely to be diagnosed with Type 2 diabetes compared to non-Hispanic whites.
- Hispanic youths have higher smoking rates - 28 percent of Hispanic eighth grade children smoked compared to 23.7 percent of non-Hispanic white children.
- Preschool-age Hispanic children are four times more likely to be obese compared to non-Hispanic white children. Obese children are more likely to develop cardiovascular disease and diabetes as young adults.
- Mexican Americans are more likely to be hospitalized for a heart attack compared to non-Hispanic whites.
- Mexican Americans are twice as likely to have an ischemic stroke (caused by narrowed arteries) before age 60 compared to non-Hispanic whites.
- "One of the gaps is that of the little research we have, most of it focuses on Mexican Americans," Rodriguez said. "There is still a lot we don't know about cardiovascular risk and disease in the many other Hispanic populations."
Hispanics include a diverse population with origins in Mexico, Puerto Rico, Cuba, the Dominican Republic and Central and South America.
Customized approaches are needed to improve cardiovascular health and facilitate the acceptance of treatments to prevent or treat heart disease and stroke. Healthcare providers, researchers and policymakers must consider cultural values and beliefs, language, the impact of acculturation and other factors when developing such strategies.
Some of the statement recommendations for improving cardiovascular health in Hispanics include:
- Train healthcare providers to provide culturally proficient healthcare to Hispanic Americans.
- Standardize health research, electronic health records, and other surveillance systems to include Hispanic subgroups based on countries of origin.
- Increase the Hispanic healthcare workforce, including Spanish-speaking physicians.
- Establish educational programs to help Hispanic Americans recognize risk factors and warning signs of stroke and heart attack.
- Implement effective heart health promotion and disease prevention strategies within Hispanic communities and public schools.
- Addressing the cardiovascular health of U.S. minority populations, such as Hispanics, will help improve the cardiovascular health of the entire U.S. as a whole.
"We need to embrace the Hispanic population and include them in the cardiovascular health goals we have for the entire country," Rodriguez said.
Co-authors are Matthew Allison, M.D., M.P.H.; Martha L. Daviglus, M.D., Ph.D.; Carmen R. Isasi, M.D., Ph.D.; Colleen Keller, Ph.D.; Enrique C. Leira, M.D., M.S.; Latha Palaniappan, M.D., M.S.; Ileana L. Piña, M.D., M.P.H.; Sarah Ramirez, Ph.D., M.P.H.; Beatriz Rodriguez, Ph.D., M.P.H.; and Mario Sims, Ph.D., M.S. Author disclosures are on the manuscript.