UM Researchers Find U.S. Hispanics at High Risk for Heart Attack or Stroke in JAMA Study
A multicenter study published in the Journal of the American Medical Association (JAMA) has found important differences in risk factors for heart attack and stroke among Hispanics of different origins living in the United States. According to the study of a large and diverse group of Hispanic adults conducted in Miami by UM researchers and by collaborators in three other U.S. cities, the risk is highest in men and older people who were born or have lived in the U.S. for more than 10 years, prefer to speak English, are lower income, or never finished high school.
“Before the study, most of what was known about the extent of heart attacks, strokes and risk factors in Hispanics came primarily from studies of Mexican-Americans, who are the largest group of Hispanics living in the U.S.,” said the Principal Investigator of the study’s Miami Field Center, Neil Schneiderman, Ph.D., the James L. Knight Professor of Psychology, who is also professor of medicine and psychiatry and behavioral sciences at the Miller School. “The findings reported in JAMA show that there are some important differences in risk factors among people from diverse Hispanic backgrounds.”
The JAMA study, “Prevalence of Major Cardiovascular Risk Factors and Cardiovascular Diseases among Hispanics/Latinos of Diverse National Backgrounds in the US,” found that risk of heart attack and stroke among Hispanics is most highly related to smoking and high blood pressure, but other risk factors are important. The treatable risk factors examined were smoking, blood pressure, cholesterol, obesity and diabetes. Using national guidelines as a comparison, the researchers found that Puerto Ricans are the most likely to have three or more risk factors, and they usually include smoking and obesity. Cubans and South Americans are the least likely to have diabetes.
The findings come from the Hispanic Community Health Study/Study of Latinos. Informally known as SOL, it is the largest study of Hispanic health ever sponsored by the National Institutes of Health (NIH), with the NIH’s National Heart, Lung and Blood Institute and six other NIH institutes, centers and offices providing support. SOL’s goal is to determine the health of Hispanics living in the U.S. and pinpoint the factors that reduce or increase the risk of chronic disease.
For the JAMA study, researchers examined 16,415 randomly selected Hispanic adults living in Miami, Chicago, New York’s Bronx, and San Diego between 2008 and 2011. The geographic diversity allowed SOL investigators to examine the health and disease risk of people from different Hispanic backgrounds, including Cubans, Dominicans, Puerto Ricans, Mexicans and other Central Americans, and South Americans.
More than 4,000 SOL participants were examined in the Miami Field Center, which is located on the seventh floor of the Clinical Research Building, and managed by another of the study’s co-authors, Marc Gellman, Ph.D., research associate professor of psychology.
The Miami participants were recruited from a randomly pre-specified list of addresses in the cities of Hialeah, Miami and Coral Gables. Although slightly more than half of the participants reported Cuban ancestry, the Center also had the opportunity to examine fairly large numbers of participants with Central or South American backgrounds.
“Because the examiners were comfortable conversing in Spanish or English, each participant was able to choose to speak in either language during the examination,” Schneiderman said. “Most chose Spanish.”
All SOL participants have annual follow-up visits. Therefore, SOL will be able to determine which risk factors and protective factors directly influence the development of heart disease, stroke, lung diseases and other chronic illnesses. Plans are for a second examination to be conducted on current SOL participants between 2014 and 2017, with follow-up continuing until 2019.
“The SOL participants and SOL investigators have developed a strong, positive, long-term relationship that will allow the Hispanic community to gain a critical understanding of the status of Hispanic health in the U.S. and the risks and protective behaviors that can influence Hispanic health,” Schneiderman said.
Also contributing to the study were researchers from the University of Illinois in Chicago, San Diego State University, the National Heart Lung and Blood Institute, the University of California, San Diego, the University of North Carolina, Northwestern University, and Albert Einstein College of Medicine.