Introduction:
Heart failure represents a significant public health problem because of increasing prevalence and lack of effective medical treatment. Hispanic/Latinos have a high burden of cardio-metabolic comorbidities and adverse socioeconomic conditions that place them at risk for heart failure. However, some literature indicates that among Hispanics/Latinos, residing in areas with high Hispanic/Latino ethnic density is associated with better health outcomes. There is a paucity of data on the effect of Hispanic/Latino ethnic density and risk markers for heart failure. Therefore, we evaluated the association between Hispanic/Latino ethnic concentration and several echocardiographic measures of left ventricular structure and function.
Methods:
Data on baseline characteristics from the Hispanic Communities Health Study/Study of Latinos (HCHS/SOL), echocardiographic measures of cardiac structure and function (ECHO-SOL), and neighborhood Hispanic/Latino ethnic density (San Diego SOL-CASAS) were analyzed. Hispanic/Latino ethnic density was calculated for each person based on an 800-m buffer around their home. Hispanic/Latino ethnic density was then calculated using data from the 2010 Census as the percent of Hispanic/Latinos divided by the total population at the Census block level and calculating an average value for all Census blocks that overlapped with the participant's address. Multivariable linear regression analysis adjusting for personal demographics and cardiovascular risk factors was conducted.
Results:
A total of 350 participants with data from all three databases were included in the analysis. The mean age was 55±7 years, 69% were female, and 26%, 38%, and 43% had diabetes, hypertension, and dyslipidemia, respectively. Thirty-six percent had less than high school education, and 58% were low income. In models adjusting for age, sex, education level, income, acculturation, and cardiovascular risk factors, a 1-percent higher Hispanic/Latino ethnic density was associated with lower left ventricular mass (0.47, p-value = 0.02). Other echocardiographic measures of cardiac structure and function were not significantly related to Hispanic/Latino ethnic density.
Conclusion:
Higher Hispanic/Latino ethnic density was associated with lower LVM independent of personal SES and common cardiovascular risk factors. These findings suggest that Hispanic/Latinos residing in areas with higher Hispanic/Latino ethnic density might have a lower risk of future HF. However, further research to understand the specific factors that mediate the observed associations are necessary.
Deterioration in right ventricular structure and function over time in patients with heart failure and preserved ejection fraction