Association of birthplace and occupational exposures with chronic bronchitis in US Hispanics/Latinos, 2008–2011

ObjectivesIn the US, chronic bronchitis (CB) is common and is associated with substantial morbidity and mortality. Data on CB in the Hispanic/Latino population—a large, diverse US minority—are scarce. We aimed to test whether the prevalence of CB varies across Hispanic/Latino heritages and to identify CB risk factors, including occupational exposures, in this population.MethodsWe analysed data from the Hispanic Community Health Study/Study of Latinos, a US population-based probability sample of participants aged 18–74 years (n=16 415) including those with Mexican, Puerto Rican, Dominican, Cuban, Central American and South American heritages. Participants who had a completed respiratory questionnaire and valid spirometric data were included in the analysis (n=13 259). CB, place of birth, heritage, occupational exposures and other risk factors were based on standardised questionnaires. The prevalence of CB was estimated using survey logistic regression-conditional marginal analysis.ResultsThe estimated (mean (95% CI)) overall adjusted prevalence of CB was 12.1% (9.3 to 15.6), with a large variation across heritages. Dominican heritage had a fivefold higher prevalence than South American heritage. US-born participants had a higher adjusted prevalence than their non-US-born counterparts (16.8% (12.5 to 22.1) vs 11.0% (8.5 to 14.10); p=0.022). Compared with non-exposed participants, those exposed to cleaning or disinfecting solutions had a higher adjusted prevalence of CB (12.6% (9.1 to 17.1) vs 11.8% (9.2 to 15.1); p=0.024).ConclusionsThe prevalence of CB was higher among Dominicans than other Hispanic/Latino heritages. CB was more prevalent among US-born participants and those exposed to cleaning and disinfecting solutions.

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Chronic bronchitis: High prevalence in never smokers and underdiagnosis— A population-based study in Colombia

Chronic Respiratory Disease ◽

10.1177/1479972318769771 ◽

2018 ◽

Vol 16 ◽

pp. 147997231876977 ◽

Cited By ~ 3

Author(s):

Mauricio Gonzalez-Garcia ◽

Andres Caballero ◽

Claudia Jaramillo ◽

Carlos A Torres-Duque

Keyword(s):

Risk Factors ◽

Chronic Bronchitis ◽

Sampling Technique ◽

Occupational Exposures ◽

Population Based ◽

Cross Sectional Study ◽

Wood Smoke ◽

Common Disease ◽

Cross Sectional ◽

Adjusted Risk

The objective of the article was to establish the prevalence, underdiagnosis, and risk factors of chronic bronchitis (CB) in a general population in five Colombian cities. Cross-sectional study using a probabilistic sampling technique in five Colombian cities was adopted. The CB definition was “cough and expectoration for three or more months per year for at least two consecutive years.” Underdiagnosis was considered in subjects with clinical definition without previous medical diagnosis. Univariate χ2 or Student’s t-test and logistic regression analysis were used. The study included 5539 subjects. The prevalence was 5.5%, the underdiagnosis 50.3%, and 33.7% of the cases were in nonsmokers (53.6% in women vs. 16.9% in men, p < 0.001). The adjusted risk factors were living in Bogota, current smoking, male, age ≥ 64 years, low education, indoor wood smoke exposure, and occupational exposure to vapors, gases, dust, and fumes. CB is a common disease among adults in Colombia. The underdiagnosis was high and there were a large proportion of cases in nonsmokers, particularly in women. Our findings support the association of CB with indoor wood smoke and occupational exposures.

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Abstract P161: Peripheral Arterial Disease in Hispanic Communities: Results from the Hispanic Community Health Study/Study of Latinos

Circulation ◽

10.1161/circ.131.suppl_1.p161 ◽

2015 ◽

Vol 131 (suppl_1) ◽

Author(s):

Matthew A Allison ◽

Franklyn Gonzales ◽

Leopoldo Raij ◽

Robert Kaplan ◽

Robert Ostfeld ◽

...

Keyword(s):

Peripheral Arterial Disease ◽

Puerto Rican ◽

Mexican Americans ◽

Arterial Disease ◽

Central American ◽

Health Study ◽

South American ◽

Hispanic Community ◽

Peripheral Arterial ◽

Cuban Americans

Background: Compared to non-Hispanic Whites, Hispanic Americans have a significantly lower prevalence of peripheral arterial disease (PAD). Since Hispanic ethnicity in the United States is heterogeneous, the purpose of this study was to determine the differential odds for PAD by Hispanic/Latino subgroup. Methods: Subjects were 9,648 men and women over the age of 45 years enrolled in the Hispanic Community Health Study - Study of Latinos (HCHS-SOL) who were evaluated by extensive survey information, relevant physical measurements and fasting blood assays. The ankle brachial index (ABI) was computed as the higher of the posterior tibial and dorsalis pedis systolic blood pressures (SBP) for each leg divided by the higher brachial artery SBP. The index ABI was the lower of the two. An ABI ≤ 0.90 was criterion for the presence of PAD. Results: The mean age was 56 years and 62% were female. Thirty percent were Mexican American, while 27% were Cuban American, 19% Puerto Rican American, 9% Dominican American, 7% Central American, 5% South American and 3% Mixed or Other Hispanic ethnicities. Overall, the prevalence of an ABI ≤ 0.90 (PAD), 0.90 to 0.99 (borderline), 1.0 to 1.39 (normal) and ≥ 1.40 (high) was 5.7, 19.3, 72.5 and 2.6%, respectively. Cuban Americans had the highest prevalence of PAD (9.1%), followed by Puerto Rican (5.9%), Central American (5.3%), Mixed/Other (5.0%), Dominican (4.7%), South American (4.6%) and Mexican Americans (3.2%). The prevalence of an ABI ≥ 1.40 ranged from 3.1% (South Americans) to 0.6% (Mixed/Other). After multivariable adjustment, and compared to Mexican Americans, Cuban Americans had nearly a 3-fold higher odds for PAD (OR = 2.85). The odds of PAD for the other Hispanic/Latino groups ranged from 1.23 to 1.82. Although males had over a 3-fold higher odds of an ABI ≥ 1.40 (OR = 3.55), the odds did not differ significantly by Hispanic/Latino ethnicity. Conclusions: Compared to Mexican Americans, all other Hispanic/Latino ethnic groups have a significantly higher odds of having PAD, with the odds being nearly 3-fold higher among Cuban Americans.

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Abstract MP024: Increase in Adverse Cardiovascular Risk Profile among Hispanics/Latinos of Diverse Backgrounds Living in the United States: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Circulation ◽

10.1161/circ.135.suppl_1.mp024 ◽

2017 ◽

Vol 135 (suppl_1) ◽

Author(s):

Martha L Daviglus ◽

Jianwen Cai ◽

Amber Pirzada ◽

Nicole M Butera ◽

Ramon A Durazo-Arvizu ◽

...

Keyword(s):

Sex Education ◽

Multinomial Logistic Regression ◽

The United States ◽

Central American ◽

Health Study ◽

Sociocultural Factors ◽

South American ◽

Cvd Risk ◽

Hispanic Community ◽

Latino Adults

Background: HCHS/SOL showed that a sizeable proportion of Hispanics/Latinos (80% of men, 71% of women) had at least 1 major CVD risk factor (RF), with marked variations by ethnic background. Little is known about changes in CVD RF profiles over time in this population. Objective: To describe ~6-year changes in CVD RF profiles and examine associations with demographic and socioeconomic/ sociocultural factors. Methods: HCHS/SOL is a multi-center prospective community-based study of 16,415 Hispanic/Latino adults of Cuban, Dominican, Mexican, Puerto Rican, Central American, and South American backgrounds, aged 18-74 at Visit 1 (2008-11). Visit 2 (2014-17) is ongoing and 8,413 persons (~60% of the cohort to be studied) attended as of Sept. 2016. Analyses included 7,789 men and women with complete data. CVD RF profiles were defined as having 0 (0RF) or any 1 or more (1+RF) of the following: hypercholesterolemia, hypertension, obesity, diabetes, and smoking (see definitions in Table). Adjusted percent increases in number of RFs were computed. Multinomial logistic regression was used to examine associations of Visit 1 characteristics with change in RFs, adjusted for sociodemographic, sociocultural, and lifestyle factors. Results: After 5.8 years, 29% of men and 27% of women had increases in number of RFs; changes occurred more frequently in persons with 1+ RF at Visit 1 than in those with 0RF and varied by background ( Table ). Significantly higher odds of increase in number of RFs (vs. 0RF at both visits) were seen with older age (OR=1.07, 95% CI=1.06-1.08 per 1 yr) and male sex (1.74, 1.37-2.21); lower odds with higher education (0.60; 0.44-0.83 for > vs. < high school) and income (0.56, 0.38-0.81 for >$50,000 vs. <$20,000); acculturation did not relate to RF changes. Conclusions: In just a few years, a large percent of US Hispanic/Latino adults had an increase in number of adverse RFs, which varied by background; age, sex, education, and income were associated with RF increases. Greater efforts are needed to prevent CVD RFs in this population.

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Abstract 009: Incidence of Hypertension among Diverse US Hispanics/Latinos: Findings from the Hispanic Community Health Study/Study of Latinos

Circulation ◽

10.1161/circ.137.suppl_1.009 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Tali Elfassy ◽

Jianwen Cai ◽

Pedro Baldoni ◽

Maria M Llabre ◽

Adina Zeki Al Hazzouri ◽

...

Keyword(s):

Community Health ◽

Puerto Rican ◽

Survey Design ◽

Incidence Rates ◽

Central American ◽

Health Study ◽

South American ◽

Sampling Weights ◽

Hispanic Community ◽

The Us

Introduction: Hypertension (HTN) is a major contributor to cardiovascular disease, the leading cause of death in the US. Yet, among diverse US Hispanics/Latinos, one of the fastest growing ethnic minority populations in the US, incident rates of HTN are currently unknown. Objectives: To determine rates of incident HTN over six years among diverse US Hispanics/Latinos and evaluate whether rates differed by Hispanic/Latino background. Methods: The Hispanic Community Health Study/Study of Latinos is an ongoing prospective population-based study of 16,415 diverse Hispanics/Latinos, ages 18-74 years, from four US communities sampled through a stratified multi-stage area probability design. Baseline examination was conducted in 2008-2011. Systolic and diastolic blood pressure (BP), as the average of three seated measurements, was measured at baseline and at an ongoing second visit (2014-2017). At each visit, HTN was defined as systolic BP ≥ 140 mmHg, diastolic BP ≥ 90 mmHg, or use of anti HTN medication. This analysis includes 7,258 adults who were free of HTN at baseline and attended the second study visit by August, 2 nd , 2017. Age adjusted, sex stratified, HTN incidence rates (IR) were calculated in person-years (PY) by Hispanic/Latino background. All analyses were weighted by nonresponse adjusted, trimmed, and calibrated sampling weights and took into account the complex survey design. Results: At baseline, age distributions were similar for men and women with: 40% age 18-34, 38% age 35-49, and 22% age 50 - 74; mean follow-up time was 5.7 years. Among 2,694 men, a total of 539 developed HTN for an overall age-adjusted IR of 25.7/1,000PY (95% CI: 22.8, 28.9). Among men, compared with Mexican background (IR: 20.5, 95% CI: 16.6, 25.2), the age adjusted IR of HTN per 1,000 PY was higher among Hispanics/Latinos of Dominican (IR: 39.2, 95% CI: 28.4, 54.0; p<0.01) and Cuban (IR: 30.6, 95% CI: 25.2, 37.2; p<0.01) background, but comparable among Central American (IR: 19.7, 95% CI: 14.1, 27.6; p=0.86), Puerto Rican (IR: 28.3, 95% CI: 20.5, 39.0; p=0.09), and South American (IR: 18.8, 95% CI: 11.5, 30.7; p=0.75) background. Among 4,564 women, a total of 855 developed HTN for an overall age-adjusted IR of 25.6/1,000PY (95% CI: 23.1, 28.3). Among women, compared with Mexican background (IR: 20.1, 95% CI: 17.0, 23.8), the age adjusted IR of HTN per 1,000 PY was higher among Hispanic/Latinos of Dominican (IR: 32.7, 95% CI: 24.3, 44.1; p<0.01), Cuban (IR: 26.8, 95% CI: 21.3, 33.6; p<0.05), and Puerto Rican (IR: 35.1, 95% CI: 27.4, 45.1; p<0.01) background, and comparable among Central American (IR: 23.2, 95% CI: 18.4, 29.3; p=0.31) and South American (IR: 24.3, 95% CI: 18.5, 31.8; p=0.24) background. Conclusions: Among a large sample of US Hispanics/Latinos free of HTN, age adjusted IRs of hypertension differed substantially by Hispanic/Latino background, being highest among those of Caribbean background.

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Abstract P446: Hispanics/Latinos With Prediabetes are Eligible for Diabetes Prevention Intervention: Findings From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Circulation ◽

10.1161/circ.141.suppl_1.p446 ◽

2020 ◽

Vol 141 (Suppl_1) ◽

Author(s):

Christina G Hutten Selkirk ◽

Carlos Sanchez ◽

Amber Pirzada ◽

Donghong Wu ◽

Larissa Aviles-Santa ◽

...

Keyword(s):

Puerto Rican ◽

Central American ◽

Health Study ◽

Oral Glucose ◽

South American ◽

Family History Of Diabetes ◽

Metformin Therapy ◽

Mexican Heritage ◽

Lifestyle Measures ◽

American Heritage

Background: Hispanics/Latinos in the US are at high risk of type 2 diabetes mellitus (T2D). The American Diabetes Association (ADA) consensus statement recommends prediabetes screening in persons with body mass index (BMI) ≥ 25 kg/m 2 from at-risk racial/ethnic groups and/or with additional T2D risk factors to identify those who may benefit from lifestyle and/or pharmacological (metformin) therapy to prevent T2D. Little is known about the proportion of diverse Hispanics/Latinos who have prediabetes and may benefit from such preventive measures. Objectives: This study examined prediabetes prevalence in Hispanics/Latinos by BMI categories to estimate the proportion eligible for preventive therapy per ADA guidelines. Methods: The HCHS/SOL is a prospective, multi-center, population-based study that enrolled 16,415 diverse Hispanic/Latino adults aged 18-74 years from four US communities in 2008 – 2011. Prediabetes was defined per ADA criteria as any of the following: fasting plasma glucose 100-125 mg/dL, oral glucose tolerance test 140-199 mg/dL, or hemoglobin A1C 5.7%-6.4%. Prevalence of prediabetes age-standardized to the 2010 US population was examined in persons aged 18-74 years with BMI ≥ 25 kg/m 2 who were free of diabetes and not taking anti-glycemic medication (n=9393) and a sub-sample of those aged 18-60 with BMI ≥ 35 kg/m 2 (n=1528) to determine eligibility for preventive lifestyle and pharmacological therapy, respectively. Overall and heritage specific prevalence estimates (95% confidence intervals) were computed. Analyses were weighted for sampling probability and non-response. Results: Among individuals with BMI ≥ 25 kg/m 2 , 50.9% (49.6 - 52.3) had prediabetes, i.e., could benefit from preventive lifestyle measures. Prevalence was highest in those of Mexican heritage (53.1%; 50.8 – 55.4), followed by Puerto Rican (49.8%; 46.2 – 53.4) and Central American (49.8%; 45.5 – 54.1) heritage. Persons of South American heritage had the lowest prevalence (45.6%; 41.4 – 49.6) (p=0.29 for overall differences across groups). Among persons with BMI ≥ 35 kg/m 2 , 55.7% (52.2 – 59.2) had prediabetes, i.e., could benefit from metformin therapy; prevalence was highest in persons of South American heritage (62.2%; 48.3 – 76.1). Of those who met the criteria for lifestyle measures, about 64% were age 18-44, 69% had at least a high school education, 41% had income <$20,000, and 40% had family history of diabetes. Over 60% of those eligible for preventive metformin therapy were women. Conclusions: Among Hispanics/Latinos who are overweight/obese, over half of those of Mexican heritage and almost half of those of Puerto Rican and Central American heritage need intensive lifestyle measures to prevent progression to diabetes. Among those who are obese, six out of ten individuals of South American heritage met criteria for preventive metformin therapy.

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Cardiovascular Disease Risk Factors in the Hispanic/Latino Population: Lessons From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

Progress in Cardiovascular Diseases ◽

10.1016/j.pcad.2014.07.006 ◽

2014 ◽

Vol 57 (3) ◽

pp. 230-236 ◽

Cited By ~ 67

Author(s):

Martha L. Daviglus ◽

Amber Pirzada ◽

Gregory A. Talavera

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Community Health ◽

Disease Risk ◽

Cardiovascular Disease Risk ◽

Cardiovascular Disease Risk Factors ◽

Health Study ◽

Latino Population ◽

Hispanic Community

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Diastolic dysfunction in individuals with and without heart failure with preserved ejection fraction

Clinical Research in Cardiology ◽

10.1007/s00392-021-01907-x ◽

2021 ◽

Author(s):

Jan-Per Wenzel ◽

Ramona Bei der Kellen ◽

Christina Magnussen ◽

Stefan Blankenberg ◽

Benedikt Schrage ◽

...

Keyword(s):

Risk Factors ◽

Heart Failure ◽

Cardiovascular Risk ◽

General Population ◽

Diastolic Dysfunction ◽

Cardiovascular Risk Factors ◽

Population Based ◽

Left Ventricular ◽

Health Study ◽

Common Finding

Abstract Aim Left ventricular diastolic dysfunction (DD), a common finding in the general population, is considered to be associated with heart failure with preserved ejection faction (HFpEF). Here we evaluate the prevalence and correlates of DD in subjects with and without HFpEF in a middle-aged sample of the general population. Methods and results From the first 10,000 participants of the population-based Hamburg City Health Study (HCHS), 5913 subjects (mean age 64.4 ± 8.3 years, 51.3% females), qualified for the current analysis. Diastolic dysfunction (DD) was identified in 753 (12.7%) participants. Of those, 11.2% showed DD without HFpEF (ALVDD) while 1.3% suffered from DD with HFpEF (DDwHFpEF). In multivariable regression analysis adjusted for major cardiovascular risk factors, ALVDD was associated with arterial hypertension (OR 2.0, p < 0.001) and HbA1c (OR 1.2, p = 0.007). Associations of both ALVDD and DDwHFpEF were: age (OR 1.7, p < 0.001; OR 2.7, p < 0.001), BMI (OR 1.2, p < 0.001; OR 1.6, p = 0.001), and left ventricular mass index (LVMI). In contrast, female sex (OR 2.5, p = 0.006), atrial fibrillation (OR 2.6, p = 0.024), CAD (OR 7.2, p < 0.001) COPD (OR 3.9, p < 0.001), and QRS duration (OR 1.4, p = 0.005) were strongly associated with DDwHFpEF but not with ALVDD. Conclusion The prevalence of DD in a sample from the first 10,000 participants of the population-based HCHS was 12.7% of whom 1.3% suffered from HFpEF. DD with and without HFpEF showed significant associations with different major cardiovascular risk factors and comorbidities warranting further research for their possible role in the formation of both ALVDD and DDwHFpEF.

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Abstract P006: Cardiovascular Disease Risk Factor Burden is Associated With Hearing Loss in Young Men: The Hispanic Community Health Study/Study of Latinos

Circulation ◽

10.1161/circ.137.suppl_1.p006 ◽

2018 ◽

Vol 137 (suppl_1) ◽

Author(s):

Rachael R Baiduc ◽

Brittany Bogle ◽

Franklyn Gonzalez ◽

Elizabeth Dinces ◽

David J Lee ◽

...

Keyword(s):

Risk Factors ◽

Cardiovascular Disease ◽

Hearing Loss ◽

Total Cholesterol ◽

Young Women ◽

Young Men ◽

Health Study ◽

Cvd Risk Factors ◽

Cvd Risk ◽

Hispanic Community

Introduction: Over 30 million Americans suffer from hearing loss (HL). Studies suggest that established cardiovascular disease (CVD) risk factors may contribute to the pathophysiology of the inner ear. However, the aggregate effect of CVD risk factors on hearing is not well understood. Hypothesis: We hypothesized that high CVD risk burden is associated with worse hearing. Methods: We assessed younger (ages 18-34) and older (ages 55-64) Hispanic Community Health Study / Study of Latinos participants who underwent audiometry in 2008-11. After excluding those with conductive pathology and asymmetric HL, we randomly chose one ear for analysis. Puretone thresholds were obtained at 0.5-8 kHz; puretone average (PTA) was calculated using thresholds at 0.5, 1, 2, and 4 kHz. Low CVD risk burden was defined as having all of: blood pressure (BP) <120/<80 mmHg; total cholesterol <180 mg/dL; not currently smoking; and not having prevalent diabetes. High CVD risk burden was defined as ≥ 2 of: diabetes; currently smoking; BP >160/>100 mmHg (or antihypertensive use); and total cholesterol >240 mg/dL (or statin use). By age group and sex, we estimated hearing thresholds per frequency with linear regression models adjusted for noise exposure. Least squares estimates were calculated using strata-specific means of covariates. Estimates were compared via t-tests. Data were weighted for all analyses and accounted for clustering. Results: Among younger and older individuals in the target population (51.9% female), 28.8% had low and 5.5% had high CVD risk. Younger men with high CVD risk had worse PTA than young men with low risk (7.7 dB HL [7.0-8.4] vs. 10.5 dB HL [8.4-12.5], p =0.02), and had significantly worse thresholds at 1,3,4,6 kHz than those with low risk ( Figure ). There was no difference in PTA or thresholds at any frequency by CVD risk burden in young women, older men, or older women. Conclusions: CVD risk burden is associated with HL among young men, but not young women or older adults. CVD risk burden may be useful for identifying young men at risk for HL.

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