The Hispanic Paradox
Heart disease remains the leading cause of death among women in the United States. Awareness about heart disease among women overall has been increasing over the years. A recent survey conducted by the American Heart Association found that 62% of Caucasian women but only 34% of Hispanic women were aware that heart disease is their greatest health threat. (Mosca, Circulation 2006) Previously it was thought that Hispanic women had a lower risk of heart disease, but recent studies have shown that Hispanic women develop heart disease risk factors ten years earlier than Caucasian women. (Teeters, 2007) Little data is available regarding CVD preventive measures specific to the Hispanic/Latino population because very few trials have been conducted in this group alone. The Agency for Healthcare Research and Quality recently reported that Hispanics are 38% less likely than non-Hispanics to have visited their doctor within the past year and more than 25% of Hispanics have never had their cholesterol checked.
Hispanic women face several barriers, which may prevent access to appropriate cardiovascular screenings:
· Lack of awareness
· Decreased recognition of the value of preventive screenings
· Lack of access to culturally sensitive information
· Language barriers
· Financial constraints/lack of insurance (33% uninsured)
· Lack of transportation
· Reliance on community health centers and clinics
Scope of the Problem
The Hispanic/Latino (Cuban, Central American, Mexican, Puerto Rican, South American, Dominican, and Spanish ancestry) population is very diverse and is the fastest growing minority group in the United States.
The following are modifiable risk factors for heart disease in the Hispanic population:
· Diabetes-according to the NIH, Hispanics are almost twice as likely as whites to have diabetes
· Excess weight and obesity-according to the NIH, almost 83% of mid-life Hispanic women are overweight or obese
· The Metabolic Syndrome
· Inactivity-almost 60% of Hispanic women report that they do not exercise regularly
· Pre-hypertension-32% of Hispanic women in their early and mid fifties have pre-hypertension
· Hypertension-more than 20% of Hispanic women have high blood pressure
· Depression-Hispanic women have the highest lifetime prevalence of depression
· Smoking-approximately 11% of Hispanic women over the age of 18 smoke
· High Cholesterol-Hispanic women tend to have lower HDL cholesterol levels and higher triglyceride levels
Heart Attack Symptoms in Women
Women are more likely to experience prodromal “warning” symptoms days to weeks preceding a heart attack. These symptoms include: chest discomfort, SOB, fatigue, palpitations, anxiety, nausea/indigestion, sleep disturbances, change in appetite, visual disturbances, and changes in thought processes. The most common prodromal symptoms experienced by Hispanic women include fatigue, sleep disturbances, and anxiety. In addition, women often exhibit atypical symptoms when presenting with a heart attack. In a recent study by McSweeney, et.al presented at an American Heart Association meeting, the most frequent acute symptoms in Hispanic women were shortness of breath, discomfort in chest/back/shoulder blades, weakness, fatigue and arm weakness/heaviness.
Latino/Hispanic Heart Health Online Resources:
Latino Nutrition Coalition: www.latinonutrition.org
Go Red for Women:
Heart Truth for Latinas: www.nhlbi.nih.gov/health/hearttruth OR
Heart Healthy Latino Recipes (Platillos Latinos):
Bi-lingual Booklets on Cardiovascular Risk Factors: www.nhlbi.nih.gov/health
Heartstrong En Espanol www.heart-strong.com
Mosca, L, et.al. National Study of Women’s Awareness, Preventive Action, and Barriers to Cardiovascular Health. Circulation. 2006; 113: 525-534.
Teeters, J, et.al. Hispanic women at higher risk for heart disease. Abstract P327. American Heart Association Meeting, 2007.
Brand New Book “Take Charge: A Women’s Guide to a Healthier Heart” release date Feb 2009. For more information please visit http://heart-strong.com/Bookstore.html