Cardiovascular disease death rates vary among Hispanics in U.S.

From 2003 to 2012, the number of Hispanics in the U.S. who died due to cardiovascular disease significantly decreased, according to U.S. National Center for Health Statistics mortality records.

The analysis also found there were significant differences in cardiovascular disease mortality rates among the three largest subgroups of Hispanics in the U.S.: Mexicans, Puerto Ricans and Cubans.

Puerto Ricans and Mexicans were younger at the time of cardiovascular disease death compared with Cubans and non-Hispanic whites. After adjusting for age, Puerto Ricans and Cubans had similar cardiovascular disease mortality rates compared with non-Hispanic whites, but they had higher rates of ischemic and hypertensive heart disease.

Lead researcher Fatima Rodriguez, MD, MPH, of the Stanford University School of Medicine, and colleagues published their results online Jan. 18 in JAMA Cardiology.

“The current aggregate classification of Hispanics masks heterogeneity in the reporting of mortality due to cardiovascular disease, leading to an incomplete understanding of health risks and outcomes among Hispanic subgroups,” the researchers wrote.

By 2060, approximately one-third of U.S. residents are expected to be of Hispanic origin, according to the researchers.

For this study, the researchers analyzed data on Hispanics and non-Hispanic whites who died from cardiovascular disease from 2003 to 2012. They included 130,397 deaths for Cubans, 688,074 for Mexicans, 163,335 for Puerto Ricans and 19,357,160 deaths for non-Hispanic whites.

The mean age at death was 75 years old, while 49 percent of the people were men. The mean age at death was 67 years old for Mexicans, 68 years old for Puerto Ricans, 76 years old for non-Hispanic whites and 77 years old for Cubans.

The proportion of people who were 25 to 49 years of age at death were 19.1 percent for Mexicans, 16.4 percent for Puerto Ricans, 6.6 percent for non-Hispanic whites and 5.3 percent for Cubans.

For the entire group, the mortality rates due to cardiovascular disease decreased from a mean of 414.2 per 100,000 in 2003 to 303.3 per 100,000 in 2012. During that time period, the decline in the mortality rate for cardiovascular disease ranged from 85 per 100,000 for all Hispanic women and 144 per 100,000 for Cuban men.

The mean annual decreases in all-cause mortality, total cardiovascular disease mortality, cerebrovascular disease mortality and ischemic heart disease mortality were all significant. The researchers added that the decreased mortality occurred in similar magnitudes across racial and/or ethnic groups and sex.

Non-Hispanic whites had the highest rates of all-cause mortality (1,372.9 deaths per 100,000 men and 983.3 deaths per 100,000 women), followed by Puerto Ricans (1,285.4 deaths per 100,000 men and 844.1 deaths per 100,000 women), Cubans (1,127.6 deaths per 100,000 men and 718.1 deaths per 100,000 women) and Mexicans (1,059 deaths per 100,000 men and 763.5 deaths per 100 000 women).

Meanwhile, ischemic heart disease mortality was highest among Puerto Ricans and non-Hispanic whites and lowest in Mexicans. However, Mexicans had the highest rates of cerebrovascular disease deaths.

The researchers cited a few limitations of the study, including the potential for misclassification of race and ethnicity data, which could lead to underreporting of mortality rates. They also mentioned there could have been misclassification of the underlying cause of cardiovascular disease death. In addition, they could not measure differences in socioeconomic status, area of residence, acculturation metrics, health behaviors, variation in risk factor prevalence and other individual characteristics.

“Findings from this study suggest that aggregation of Hispanics as a single group fails to capture important differences in [cardiovascular disease] outcomes for this increasingly important and growing segment of the population,” the researchers wrote. “Public health efforts should be geared toward culturally appropriate interventions to reduce the bur- den of [cardiovascular disease] risk factors in this diverse population.”