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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