Significant differences were found between the three largest U.S. Hispanic subgroups in CVD mortality rates, suggesting that aggregating these groups leads to an incomplete understanding of health risks and outcomes in Hispanic people, according to new data.
“Differences in CVD mortality across the three largest Hispanic subgroups in the United States (Mexicans, Puerto Ricans and Cubans) are particularly intriguing because these distinct groups vary widely in immigration histories, socioeconomic status, culture, lifestyles and risk factors,” Fatima Rodriguez, MD, MPH, of the division of cardiovascular medicine at Stanford University School of Medicine, and colleagues wrote. “The current aggregation of these diverse Hispanic subgroups in mortality reporting has led to an incomplete understanding of specific health risks and outcomes in each unique subgroup.”
Rodriguez and colleagues collected mortality data for Mexican, Puerto Rican and Cuban individuals from 2003 to 2012. Cause of death was determined through ICD-10 codes.
Mexican and Puerto Rican individuals were on average a decade younger at the time of death vs. Cuban individuals and non-Hispanic whites (Mexican mean age, 67 years; Puerto Rican mean age, 68 years; Cuban mean age, 77 years; non-Hispanic white mean age, 76 years). More Mexican (19.5%) and Puerto Rican people (16.4%) died at a young age (25-49 years) vs. Cuban (5.3%) and non-Hispanic white people (6.6%).
CVD was the leading cause of death in all subgroups, but a higher portion of deaths in the Cuban subgroup (37.6%) were CVD.
Puerto Rican individuals (1,285.4 deaths per 100,000 men; 844.1 deaths per 100,000 women) experienced similar rates of all-cause mortality as non-Hispanic white people (1,372.9 deaths per 100,000 men; 983.3 deaths per 100,000 women), followed by Cuban individuals (1,127.6 deaths per 100,000 men; 718.1 deaths per 100,000 women) and Mexican individuals (1,059 deaths per 100,000 men; 763.5 deaths per 100,000 women).
Similar patterns were seen in CVD mortality rates. Mortality due to ischemic heart disease was highest in the Puerto Rican group (265.7 deaths per 100,000 men; 171.8 deaths per 100,000 women) and the non-Hispanic whites group (263.5 deaths per 100,000 men; 148.2 deaths per 100,000 women), with the Mexican group having the lowest rate (196.9 deaths per 100,000 men; 124.4 deaths per 100,000 women). However, the Mexican cohort had the highest rates of cerebrovascular disease deaths (63.4 deaths per 100,000 men; 57.5 deaths per 100,000 women) vs. the other subgroups.
“Finding from this study suggest that aggregation of Hispanics as a single group fails to capture important differences in CVD outcomes for this increasingly important and growing segment of the population,” the researchers wrote.
Martha L. Daviglus, MD, PhD, from the Institute for Minority Health Research at University of Illinois, Chicago, and the department of preventive medicine at Northwestern University, and colleagues wrote in an accompanying editorial: “While the underlying causes for such variations have yet to be fully ascertained, the implication is clear: There is a pressing need both for further research that includes diverse Hispanic/Latino persons and for interventions to address the burden of CVD risk through timely public health strategies promoting nutritional and other healthy lifestyles tailored to the diverse backgrounds of the heterogeneous population and culture.” – by Cassie Homer
Disclosure: The researchers and editorial authors report no relevant financial disclosures.