Hispanic Americans need tailored heart care: report
NEW YORK (Reuters Health) - Hispanic Americans make up the fastest growing minority group in the U.S. and healthcare professionals need to better understand their unique heart health risks in order to tailor their care, according to a new report from the American Heart Association.
That’s not to say the 53 million U.S. Hispanics are all the same, the authors emphasize in their review of research detailing health-related traits and trends among groups of people whose origins are in the Spanish-speaking countries of the Americas and Caribbean.
“We hope that we can move into a new era when we can look at this population with a more nuanced perspective,” said Dr. Carlos Rodriguez, the report’s lead author and a cardiologist at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.
Cardiovascular disease includes conditions that affect the heart and blood vessels, such as heart failure, strokes and high blood pressure.
The size and growth of the U.S. Hispanic community makes the group’s health vital to the nation and to reaching the American Heart Association’s 2020 goals, Rodriguez and his co-authors write in the journal Circulation.
The 2020 goals aim to improve the cardiovascular health of all Americans while reducing deaths from cardiovascular diseases by 20 percent between 2011 and 2020.
“For us to meet those goals and for us to be a healthy population and a healthy country, all groups have to be accounted for,” Rodriguez said.
The working group that produced the new report combed through medical literature to summarize what is known about the health of Hispanic Americans, identify gaps in the research that need to be filled and come up with recommendations for healthcare providers. In total, they summarize findings from 400 studies and articles.
Much of the information on cardiovascular disease, they found, is focused on Mexican Americans, which may give an inaccurate view of the health of other Hispanic populations, such as people from South America and Puerto Rico.
The report notes that about a third of Mexican Americans have cardiovascular disease, which is slightly lower than non-Hispanic whites and considerably lower than non-Hispanic blacks.
While heart disease appears to be less common overall among Hispanic Americans, the researchers found a number of specific risks that seem to afflict Hispanics more than other racial and ethnic groups.
For example, Mexican Americans are twice as likely to have a stroke before age 60 and are more likely to be hospitalized for heart attacks than non-Hispanic Americans.
“We found Hispanics have high rates of diabetes, high rates of high cholesterol and really very prevalent within this population is poor access to care and economic challenges that impact on healthcare,” Rodriguez said.
Hispanic American children are also more likely to be obese than non-Hispanic white children.
And while Hispanics are less likely to smoke as a group, certain subpopulations including Mexican and Cuban men and Puerto Rican women have smoking rates much higher than the national average.
Noting the racial diversity of certain Caribbean and Latin American countries, the researchers point out that some Hispanic Americans may also have risk factors associated with African, Asian or Amerindian roots.
“The recognition that the Latin groups have become our largest minority group and recognizing the diversity within them and paying attention to some of the special issues that they bring is certainly a step in the right direction,” Dr. Hal Strelnick said.
Strelnick was not involved with the new report but is dean of community engagement at the Albert Einstein College of Medicine of Yeshiva University in Bronx, New York.
“I think one could say that the study is long overdue but it’s certainly welcomed,” he said.
The working group included lists of policy recommendations as well as dos and don’ts for healthcare providers in their report.
Those recommendations include educating healthcare providers to tailor their care to language and cultural traits of Hispanic patients, better identifying subgroups by including countries of origin or descent in medical records and increasing the Hispanic healthcare workforce.
The report authors also suggest that U.S. screenings for cardiovascular disease begin at a younger age for Hispanics, because the condition tends to start earlier in that population.
The American Heart Association recommends that all Americans get active, control their cholesterol, eat better, manage blood pressure, lose weight, reduce blood sugar and stop smoking to improve their cardiovascular health.
SOURCE: bit.ly/1sSvWGC Circulation, July 14, 2014.