In the Journals

High education attainment confers similar CVD risk in Hispanic, non-Hispanic white patients

Hispanic and non-Hispanic white patients who attained high levels of education had a similar risk for atherosclerotic CVD, mortality and subclinical coronary atherosclerosis, according to a study published in JAMA Cardiology.

Fatima Rodriguez, MD, MPH, assistant professor of medicine at Stanford University Medical Center, and colleagues analyzed data from 45,087 patients from the Cooper Center Longitudinal Study who were Hispanic (n = 1,351) or non-Hispanic white (n = 43,736) and underwent preventive medicine examinations from October 1972 to November 2017. Patients were aged 20 to 80 years and had a BMI between 18.5 kg/m2 and 50 kg/m2.

Information assessed in this study included triglycerides, BP, glucose and HDL. Patients completed a medical questionnaire to collect information on family and personal history. Anthropometric measurements were taken during a physical examination. Metabolic equivalent tasks were used to estimate aerobic capacity. Researchers calculated 10-year risk for atherosclerotic CVD through Pooled Cohort Equations.

A subset of Hispanic patients (n = 655) older than 40 years underwent coronary artery calcium testing between January 1998 and November 2017. These patients were matched by age and sex to 21,284 non-Hispanic white patients.

There was no statistical difference between Hispanic and non-Hispanic white patients regarding educational attainment levels for men and women.

Metabolic syndrome was more prevalent in Hispanic women compared with non-Hispanic white women (13.1% vs. 10.8%). This was also seen in Hispanic men vs. non-Hispanic white men (30.6% vs. 26.3%).

Compared with non-Hispanic white women, Hispanic women were twice as likely to have diabetes (OR = 2.07; 95% CI, 1.25-3.43). Hispanic men had similar patterns for diabetes.

Hispanic men and women had lower estimated 10-year risk for atherosclerotic CVD vs. non-Hispanic white men and women. This difference disappeared after adjusting for age, examination year and educational attainment.

During a mean follow-up of 3.6 years, cardiometabolic parameters significantly worsened for both Hispanic and non-Hispanic white patients, although the differences between groups were not statistically significant.

Of the patients who underwent CAC scoring, the difference between Hispanic women was not significantly greater compared with non-Hispanic white women (20.9% vs. 16.2%, respectively). Hispanic men had similar CAC prevalence vs. non-Hispanic white men (46.4% vs. 44.4%, respectively).

During a mean follow-up of 12.9 years, there were no differences in the rate of all-cause mortality in Hispanic and non-Hispanic white patients.

“These findings do not support the Hispanic paradox in a highly educated Hispanic population,” Rodriguez and colleagues wrote. “More work is needed to understand the relationship between [socioeconomic status], cardiovascular risk and outcomes in Hispanic individuals.” – by Darlene Dobkowski

Disclosures: The authors report no relevant financial disclosures.

Hispanic and non-Hispanic white patients who attained high levels of education had a similar risk for atherosclerotic CVD, mortality and subclinical coronary atherosclerosis, according to a study published in JAMA Cardiology.

Fatima Rodriguez, MD, MPH, assistant professor of medicine at Stanford University Medical Center, and colleagues analyzed data from 45,087 patients from the Cooper Center Longitudinal Study who were Hispanic (n = 1,351) or non-Hispanic white (n = 43,736) and underwent preventive medicine examinations from October 1972 to November 2017. Patients were aged 20 to 80 years and had a BMI between 18.5 kg/m2 and 50 kg/m2.

Information assessed in this study included triglycerides, BP, glucose and HDL. Patients completed a medical questionnaire to collect information on family and personal history. Anthropometric measurements were taken during a physical examination. Metabolic equivalent tasks were used to estimate aerobic capacity. Researchers calculated 10-year risk for atherosclerotic CVD through Pooled Cohort Equations.

A subset of Hispanic patients (n = 655) older than 40 years underwent coronary artery calcium testing between January 1998 and November 2017. These patients were matched by age and sex to 21,284 non-Hispanic white patients.

There was no statistical difference between Hispanic and non-Hispanic white patients regarding educational attainment levels for men and women.

Metabolic syndrome was more prevalent in Hispanic women compared with non-Hispanic white women (13.1% vs. 10.8%). This was also seen in Hispanic men vs. non-Hispanic white men (30.6% vs. 26.3%).

Compared with non-Hispanic white women, Hispanic women were twice as likely to have diabetes (OR = 2.07; 95% CI, 1.25-3.43). Hispanic men had similar patterns for diabetes.

Hispanic men and women had lower estimated 10-year risk for atherosclerotic CVD vs. non-Hispanic white men and women. This difference disappeared after adjusting for age, examination year and educational attainment.

During a mean follow-up of 3.6 years, cardiometabolic parameters significantly worsened for both Hispanic and non-Hispanic white patients, although the differences between groups were not statistically significant.

Of the patients who underwent CAC scoring, the difference between Hispanic women was not significantly greater compared with non-Hispanic white women (20.9% vs. 16.2%, respectively). Hispanic men had similar CAC prevalence vs. non-Hispanic white men (46.4% vs. 44.4%, respectively).

During a mean follow-up of 12.9 years, there were no differences in the rate of all-cause mortality in Hispanic and non-Hispanic white patients.

“These findings do not support the Hispanic paradox in a highly educated Hispanic population,” Rodriguez and colleagues wrote. “More work is needed to understand the relationship between [socioeconomic status], cardiovascular risk and outcomes in Hispanic individuals.” – by Darlene Dobkowski

Disclosures: The authors report no relevant financial disclosures.