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

Circulation ◽  
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.

scholarly journals Sleep Apnea Is Independently Associated With Peripheral Arterial Disease in the Hispanic Community Health Study/Study of Latinos

2015 ◽  
Vol 35 (3) ◽  
pp. 710-715 ◽  
Author(s):  
Neomi Shah ◽  
Matthew Allison ◽  
Yanping Teng ◽  
Sylvia Wassertheil-Smoller ◽  
Daniela Sotres-Alvarez ◽  
...  
Keyword(s):  
Sleep Apnea ◽  
Peripheral Arterial Disease ◽  
Community Health ◽  
Arterial Disease ◽  
Health Study ◽  
Hispanic Community ◽  
Peripheral Arterial

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

Circulation ◽  
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.

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

2020 ◽  
Vol 77 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Victor Kim ◽  
Wei Wang ◽  
David Mannino ◽  
Alejandro Diaz
Keyword(s):  
Risk Factors ◽  
Chronic Bronchitis ◽  
Occupational Exposures ◽  
Population Based ◽  
Central American ◽  
Health Study ◽  
Mortality Data ◽  
South American ◽  
Hispanic Community ◽  
American Heritage

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.

Abstract 3113: Uncontrolled Hypertension, Systolic and Diastolic Blood Pressure and Development of Symptomatic Peripheral Arterial Disease in the Women’s Health Study

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Tiffany M Powell ◽  
Robert J Glynn ◽  
Mark A Creager ◽  
Paul M Ridker ◽  
Aruna D Pradhan
Keyword(s):  
Blood Pressure ◽  
Peripheral Arterial Disease ◽  
Systolic Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Arterial Disease ◽  
Uncontrolled Hypertension ◽  
Health Study ◽  
Adjusted Risk ◽  
Treatment Status ◽  
Peripheral Arterial

Background : Prospective data pertaining to risk factors for peripheral arterial disease (PAD) in women are sparse. Few studies have evaluated blood pressure, including uncontrolled hypertension, and PAD onset in women. Methods and Results : We examined the relationship between blood pressure and development of confirmed symptomatic PAD (n=116 events) in a prospective cohort study of 39,261 female health professionals aged ≤ 45 years without diagnosed vascular disease at baseline. Median follow-up was 11.4 years. Women were first grouped according to baseline presence of uncontrolled hypertension, defined as reported systolic blood pressure (SBP)≥ 140 mmHg and/or diastolic blood pressure (DBP) ≥ 90 mmHg, and pharmacologic treatment status. SBP and DBP were then modeled as continuous and categorical exposures irrespective of treatment status. Pulse pressure (PP) and mean arterial pressure (MAP) were also assessed. Age-adjusted and multivariable-adjusted risk estimates were derived from Cox proportional hazards models. Women with treated but uncontrolled hypertension had the highest risk of symptomatic PAD (0.67 events per 1000 person-years). Adjusted hazard ratios (HRs) compared to women without hypertension were 1.1 (95% CI, 0.5–2.3) for women who were treated and controlled, 1.7 (95% CI, 1.0 –3.0) for women untreated and uncontrolled, and 2.3 (95% CI, 1.4 – 4.0) for women treated and uncontrolled (p-trend<0.001). When hypertension was examined using continuous and categorical measures, there was a 33% increase in risk per 10 mmHg of SBP (95% CI, 18 to 47%) and a positive gradient in multivariable-adjusted risk according to SBP category (<120, 120 –139, 140 –159, and ≤ 160 mmHg); HRs were 1.0, 1.6, 2.8, and 4.3 (p-trend<0.001), respectively. We also considered DBP, PP, and MAP. While individually predictive, none was a stronger predictor than SBP with none adding predictive ability beyond SBP. Conclusions : Uncontrolled hypertension is associated with incident symptomatic PAD in women. Among blood pressure variables assessed, SBP is the best single predictor. These data support a strong prognostic role for systolic blood pressure in the development of peripheral atherosclerosis in women.

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 ◽  
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.

scholarly journals Cuban Americans have the highest rates of peripheral arterial disease in diverse Hispanic/Latino communities

2015 ◽  
Vol 62 (3) ◽  
pp. 665-672 ◽  
Author(s):  
Matthew A. Allison ◽  
Franklyn Gonzalez ◽  
Leopoldo Raij ◽  
Robert Kaplan ◽  
Robert J. Ostfeld ◽  
...  
Keyword(s):  
Peripheral Arterial Disease ◽  
Arterial Disease ◽  
Peripheral Arterial ◽  
Cuban Americans ◽  
Latino Communities

Abstract MP37: Association of Acculturation With Six-year Change in Systolic Blood Pressure Across Diverse Hispanic/Latino Background Groups, the Hispanic Community Health Study/Study of Latinos, 2008-2017

Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Tali Elfassy ◽  
Neil Schneiderman ◽  
Tatjana Rundek ◽  
Leopoldo Raij ◽  
Asmi Panigrahi ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Systolic Blood Pressure ◽  
Community Health ◽  
Puerto Rican ◽  
Central American ◽  
Health Study ◽  
Foreign Born ◽  
Potential Health ◽  
Hispanic Community

Introduction: Among US Hispanics/Latinos, greater acculturation to US society is associated with higher blood pressure. However, the extent to which this relationship varies across diverse Hispanic/Latino groups is unclear. Objectives: To determine whether acculturation is differentially associated with six-year change in systolic blood pressure (SBP) across Hispanic/Latino groups. Methods: The Hispanic Community Health Study/Study of Latinos is a prospective population-based study of diverse Hispanics/Latinos aged 18-74 years from four US communities. Acculturation at baseline (2008-2011) was defined by the Short Acculturation Scale for Hispanics (SASH) social and language scales (low, medium, or high acculturation) and nativity/duration of US residence (foreign-born with < 10 or ≥ 10 years of US residence, or US born-not including Puerto Rico). The average of three seated SBP measurements was used; difference in SBP from baseline to follow-up (2014-2017) was calculated in 7,836 adults free from hypertension at baseline (SBP < 140 mmHg; diastolic blood pressure < 90 mmHg; and not taking hypertension medication). Using linear regression models accounting for the complex survey design and adjusted for baseline age, sex, education, income, body mass index, years of follow-up, and hypertension medication at follow-up, we estimated the association of each measure of acculturation with change in SBP. Significant interactions between Hispanic/Latino group and measures of acculturation led to stratified models (SASH interaction p=0.01 for social; p=0.28 for language; and nativity/duration of US residence US interaction, p=0.05). Results: Mean baseline age was 36.7 years (SE: 0.23) and 51.7% were women (SE: 0.77). After an average follow-up of 6.2 years (SE: 0.02), mean change in SBP was 2.01 mmHg (SE: 0.20). Among individuals of Central American background, high vs. low SASH language was associated with +3.21 mmHg SBP increase (95% CI: 0.19, 6.24) and being US born vs. foreign-born < 10 years in US was associated with +5.31 mmHg SBP increase (95% CI: 2.10, 8.53). Among individuals of Puerto Rican background, those with ≥ 10 vs. < 10 years in the US 50 states had a 5.67 mmHg lower increase in SBP (95% CI: -9.85, -1.50). Associations between measures of acculturation and changes in SBP were not significant in other groups (i.e. Cubans, Dominicans, and South Americans), but did suggest a greater SBP increase with greater acculturation among Mexican background individuals (e.g. high vs. low SASH social β=1.67, 95% CI: -0.19, 3.52, p=0.08). Conclusions: Greater acculturation was associated with a greater SBP increase among those of Central American background but a lower SBP increase among individuals of Puerto Rican background. These findings show that consideration of Hispanic/Latino group is warranted when assessing potential health effects of acculturation.

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