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Invited Commentary
March 2017

Challenges in Assessing Cardiovascular Mortality Among Hispanic/Latino Groups in the United States

Author Affiliations
  • 1Institute for Minority Health Research, University of Illinois at Chicago
  • 2Department of Preventive Medicine, Northwestern University, Chicago, Illinois
JAMA Cardiol. 2017;2(3):248-249. doi:10.1001/jamacardio.2016.5018

Cardiovascular disease (CVD) is one of the leading causes of mortality among US Hispanic/Latino persons,1 the largest minority population in the country. It is likely that as this currently young population ages, its absolute burden of adverse CVD outcomes will increase unless timely, effective steps are taken to address its risk burden.

Despite lower socioeconomic status and higher rates of diabetes and obesity, the US Hispanic/Latino population has generally lower CVD mortality rates than the non-Hispanic population, ie, the “Hispanic paradox.”2 This has raised speculation that certain as-yet-undetermined aspects of Hispanic/Latino culture may be beneficial to cardiovascular health.3 Other researchers have contended that this phenomenon is an artifact stemming from misclassification of race/ethnicity on death certificates4 or from confounding by migration back to their countries of origin. We lack comprehensive data on CVD outcomes by Hispanic/Latino background, and it remains unclear whether the Hispanic paradox (if one exists) applies to all groups. A report from the National Longitudinal Mortality Study showed lower age-, education-, and income-adjusted total mortality hazard ratios for Mexican, Cuban, and Puerto Rican persons compared with non-Hispanic white persons; however, cause-specific mortality was not assessed.5 Hummer et al6 examined data from the National Health Interview Survey–Multiple Cause of Death linked file from 1986 to 1995. They reported that while Central/South American persons had significantly lower all-cause mortality than non-Hispanic white persons, CVD mortality was in general lower for most Hispanic/Latino groups compared with non-Hispanic white persons. Current mortality patterns may or may not reflect data from the 1980s and 1990s.

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