The Hispanic and Latino populations in the United States are vast and diverse, yet for decades, their cardiovascular health remained largely understudied. This blog explores the complex web of factors that have shaped our understanding of heart health in these communities, from the Hispanic paradox to the emerging insights from large-scale studies like the Hispanic Community Health Study/Study of Latinos. As researchers delve deeper, more questions than answers emerge, underscoring the need for a nuanced, personalized approach to addressing the unique cardiovascular challenges faced by this dynamic population.
An Exposition of the Hispanic Paradox
For years, researchers struggled to explain the ‘Hispanic paradox’ why Hispanic and Latino Americans do better on average than white Americans across a range of health outcomes, even though they are more likely to face lower income and educational levels overall. This mystery led to a cascade of investigations, and theories including healthier immigrants, self-selection of the healthiest, and the salmon effect (sick people go home).
Over time, researchers have discovered the Hispanic paradox was not as straightforward as it initially appeared. What was clear is that the Hispanic and Latino populations were not a homogeneous group, but rather a mosaic of different ethnicities, cultures, and socio-economic histories. Cardiovascular risk factors and disease prevalence in US Hispanic/Latino adults differ substantially among subgroups, but knowledge of such differences is limited; specifically, data are lacking for the largest Latino group by population size — persons of Mexican heritage.
Decoding the Enigma of Hispanic Heart Health
Results from the largest, most diverse study of Latino health in the U.S., the HCHS/SOL study provided this detailed look at what cardiovascular health looks like across Hispanic heritage groups. Hispanic had increased or equivalent risk for heart disease and stroke compared with non-Hispanic whites similarly, but risks differed significantly between Hispanic ethnic subgroups. Puerto Rican women had the highest levels of obesity, for instance, and Central American men had the highest rates of high cholesterol.
Subsequent research has also found troubling patterns, such as a quickening pace of heart failure deaths among fast-growing Hispanic adults as well a greater death toll from COVID-19 in the Hispanic community. This highlights the need to move beyond generalizing criteria and focus on the distinct difficulties various Hispanic subgroups experience. Because these populations are growing and changing quickly, there is an urgent need for targeted interventions and prevention efforts that speak directly to their communities.
Your Pathway to Health: Precision Medicine for the Hispanic Heart
While research on Hispanic cardiovascular health has seen great strides, challenging disparities persist. Experts are also calling for greater diversity in genetic studies and an end to the overreliance on data derived from insured populations, which may not reflect the experiences of uninsured or underinsured Hispanic members.
So while improved heart health outcomes for Hispanic and Latino communities may yet be possible, it will require a new approach utilizing precision medicine. Developing intervention and prevention methods should take into account the targeted social, cultural, and behavioral determinants that influence cardiovascular health in each Hispanic subgroup. Honoring the diversity within these populations and supporting researchers who recognize the value of those questions could help ensure all Hispanics and Latinos can lead healthier, longer lives.
