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 ◽  
...  

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.

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
Matthew A Allison ◽  
Franklyn Gonzales ◽  
Leopoldo Raij ◽  
Robert Kaplan ◽  
Robert Ostfeld ◽  
...  

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.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Tali Elfassy ◽  
Neil Schneiderman ◽  
Tatjana Rundek ◽  
Leopoldo Raij ◽  
Asmi Panigrahi ◽  
...  

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.


Circulation ◽  
2020 ◽  
Vol 141 (Suppl_1) ◽  
Author(s):  
Samantha Schilsky ◽  
Wayne D Rosamond ◽  
June STEVENS ◽  
Carmen R Isasi ◽  
Martha L DAVIGLUS ◽  
...  

Background: Sugar sweetened beverages (SSBs) are the largest contributor to added sugars and calories in the U.S. diet with highest intake among US Hispanics. The prevalence of obesity in adults in the US is much higher in Hispanics compared to non-Hispanic whites (47% and 38% respectively). Improving our understanding of the association between SSB and artificially sweetened beverage (ASB) consumption and measures of adiposity can inform interventions targeting overweight and obesity. Aim: Examine the independent associations of daily SSB and ASB consumption with 6-year changes in weight, waist circumference (WC) and body mass index (BMI) in Hispanics in the US. Methods: We examined 7402 adults without diabetes aged 18-74yrs at baseline (2008-11) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a multi-site community-based cohort in the US. Baseline exposures of daily SSB and ASB consumption were estimated combining two 24-hour dietary recalls and a Food Propensity Questionnaire using the NCI method to correct for measurement error and account for episodically consumed foods. Complex survey linear regression models were used to examine associations of SSBs and ASBs with 6-year change in weight (kg), WC (cm) and BMI. Models were adjusted for age, gender, center, background, education, employment, marital status, cigarette use, physical activity, healthy eating index, depressive symptoms, non-SSB sugar intake, years in the US and years between visits. Interactions of SSB and ASB with gender and years lived in the U.S. (US born, >10yr, ≤10 yr) were assessed. Results: Overall, 3326 [male=49.7%] and 1244 [male=35.7%] reported daily intake of >2 servings of SSBs and ASBs respectively whereas 2203 [male=26.1%] and 4318 [male=41.2%] reported daily intake < 1 servings of SSBs and ASBs respectively. Daily energy intake (kcal) was higher among those with higher daily SSB consumption [means=14768 and 2008 kcals; <1 serving and >2 servings, respectively] and lower with higher ASB consumption (means=1836 and 1773 kcals; <1 serving and >2 servings, respectively). Daily sugar intake independent of SSBs was higher with daily consumption of both SSB and ASB (<1 serving vs. 2 servings). Non-significant associations were found for daily SSB and ASB intake and changes in adiposity for all measures in males and females. Interaction between years in the U.S. and ASB consumption were significant only for change in weight and BMI [p<0.05]. Among those consuming <1 serving per day of ASBs, there was a larger mean change in weight and BMI for those who spent < 10yr in the U.S. compared to U.S. born. Conclusion: In this diverse Hispanic cohort, 6-year changes in measures of adiposity are not associated with daily SSB or ASB consumption. Modification of the association of ASB and measures of adiposity by years in US suggests further exploration is needed to discern its relationship among Hispanics.


2020 ◽  
Vol 77 (5) ◽  
pp. 344-350 ◽  
Author(s):  
Victor Kim ◽  
Wei Wang ◽  
David Mannino ◽  
Alejandro Diaz

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.


2015 ◽  
Vol 2015 ◽  
pp. 1-8 ◽  
Author(s):  
Carmen R. Isasi ◽  
Guadalupe X. Ayala ◽  
Daniela Sotres-Alvarez ◽  
Hala Madanat ◽  
Frank Penedo ◽  
...  

Background.The study examined the association of obesity with acculturation in a large and diverse sample of US Hispanic/Latino adults.Methods.The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a community-based cohort study of Hispanic/Latino adults aged 18–74 years (N=16,415) from four urban areas. Height and weight were directly measured using a standardized protocol. Acculturation was assessed by the Short Acculturation Scale for Hispanics (SASH). Other immigration related variables included place of birth, length of residency in the US, and age at immigration. Odds ratios were calculated to assess the association of overweight, moderate obesity, and extreme obesity (≥40 kg/m2) with acculturation and sociodemographic variables.Results.The prevalence of obesity was 42.4% for women and 36.5% for men and varied by field center and Hispanic/Latino background. The strongest predictor of moderate and extreme obesity was length of residency in mainland US. This association was consistent across Hispanic/Latino backgrounds. Acculturation was not significantly associated with obesity.Discussion.The burden of obesity is high among Hispanic/Latino adults. The study findings suggest that prolonged exposure to the environments in these communities, rather than acculturation, is an important risk factor for obesity in this population.


Circulation ◽  
2021 ◽  
Vol 143 (Suppl_1) ◽  
Author(s):  
Carlos E Rosas ◽  
Amber Pirzada ◽  
Ramon A Durazo-Arvizu ◽  
Lisa A Sanchez-Johnsen ◽  
krista perreira ◽  
...  

Introduction: Prior research on the association of anxiety with hypertension has yielded mixed results. Despite the high burden of both conditions in Hispanics/Latinos, little is known about their association in this population. This study examined the longitudinal relationship of trait anxiety with changes in BP and incidence of hypertension. Hypothesis: Higher trait anxiety at Visit 1 (V1) will be associated with greater increases in BP and incident hypertension over 6 years. Methods: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL) is a multi-center prospective community-based study of 16,415 diverse Hispanics/Latinos ages 18-74 at V1 (2008-11). Data included 11,048 participants with complete information on BP, trait anxiety, and other variables at V1 and V2 (2014-17). Trait anxiety was measured at V1 using the 10-item Spielberger Trait Anxiety Scale, which was dichotomized into low and high using a cut-point of 20 points, the top quartile in the HCHS/SOL cohort. BP was measured using a standardized protocol and validated automated device. Hypertension was defined as systolic BP ≥ 140 or diastolic BP ≥ 90 mm Hg or self-reported antihypertensive medication use. Linear regressions were used to examine the association of anxiety with BP change; to account for medication use, 9 mmHg and 6 mmHg were added to systolic and diastolic BP of treated participants, respectively. The association of anxiety with incident hypertension at V2 was examined using Poisson regression among those without hypertension at V1 ( N = 7,878). Estimates were adjusted for complex survey design, sociodemographic factors, baseline BP, antidepressant/anxiolytic medication use, and health conditions. Results: Mean baseline age was 45.8 years and 60% were women. Mean change was 3.13 ( SE = 15.67) in systolic and 0.21 ( SE = 9.73) in diastolic BP. Individuals with high, compared to those with low, trait anxiety had greater increases in systolic ( B = 1.10, 95% CI = 0.28-1.93, p = 0.009) and diastolic BP ( B = 0.69, 95% CI = 0.11-1.27, p = 0.02) over 6 years, after adjusting for covariates. Individuals with high, relative to those with low, trait anxiety had an 18% higher risk of hypertension (RR = 1.18, 95% CI = 1.03-1.34, p = 0.012). Conclusions: Elevated trait anxiety is associated with small increases in BP over 6 years and an 18% higher risk of hypertension among diverse Hispanics/Latino adults. Research on the mechanisms underlying these relationships among Hispanics/Latinos is warranted to develop effective interventions to prevent and treat hypertension in this population.


PLoS ONE ◽  
2016 ◽  
Vol 11 (1) ◽  
pp. e0146268 ◽  
Author(s):  
Frank J. Penedo ◽  
Betina Yanez ◽  
Sheila F. Castañeda ◽  
Linda Gallo ◽  
Katy Wortman ◽  
...  

Circulation ◽  
2017 ◽  
Vol 135 (suppl_1) ◽  
Author(s):  
Martha L Daviglus ◽  
Jianwen Cai ◽  
Amber Pirzada ◽  
Nicole M Butera ◽  
Ramon A Durazo-Arvizu ◽  
...  

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.


2019 ◽  
Vol 32 (9) ◽  
pp. 868-879 ◽  
Author(s):  
Tali Elfassy ◽  
Daniela Sotres-Alvarez ◽  
Linda Van Horn ◽  
Sonia Angell ◽  
Neil Schneiderman ◽  
...  

Abstract BACKGROUND High sodium and low potassium consumption are risk factors for hypertension. The objectives of this study were to describe usual daily intake of sodium and potassium among US Hispanics/Latinos of diverse background groups and estimate the proportion meeting guidelines for dietary sodium and potassium intake. METHODS We studied 16,171 participants of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), a diverse group of self-identified Hispanics/Latinos aged 18–74 years from 4 US communities. In 2008–2011, all HCHS/SOL participants underwent a standardized examination. Median usual daily intake of dietary sodium and potassium were derived from two 24-hour diet recalls; standard errors and 95% confidence intervals (CIs) were calculated using boot strap methods. Meeting 2015 US Department of Agriculture guidelines was defined as an intake of <2,300 mg/day of sodium and ≥4,700 mg/day of potassium. RESULTS Among US Hispanics/Latinos, median usual daily intake of sodium was 2,574 mg (95% CI: 2,547, 2,600) among women and 3,747 mg (95% CI: 3,697, 3,796) among men. Median usual daily intake of potassium was 2,069 mg (95% CI: 2,046, 2,092) among women and 2,649 mg (95% CI: 2,615, 2,683) among men. Overall, only 21.3% (95% CI: 20.2%, 22.4%) of the US Hispanic/Latino population met 2015 recommendations for sodium and 0.6% (95% CI: 0.4%, 0.8%) for potassium. CONCLUSIONS Among US Hispanics/Latinos intake of sodium is too high and potassium too low. Strategies to reduce sodium intake while simultaneously increasing intake of potassium in this US population are warranted.


2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1057-1057
Author(s):  
Luis Maldonado ◽  
Linda Adair ◽  
Daniela Sotres-Alvarez ◽  
Josiemer Mattei ◽  
Yasmin Mossavar-Rahmani ◽  
...  

Abstract Objectives We aimed to identify and compare a posteriori heritage-specific dietary patterns (DPs), and evaluate their associations with “healthfulness” (using Alternative Healthy Eating Index, AHEI-2010) and years living in the US. Methods We used baseline data from a population-based cohort of 14,099 Hispanics/Latinos aged 18–74 years in the Hispanic Community Health Study/Study of Latinos. We performed principal factor analysis using two 24-hr recalls to derive DPs, separately, in each heritage group (Cuban, Dominican, Mexican, Puerto Rican, Central American, South American); and identified overarching DPs based on high-loading foods shared by two or more groups. We used multivariable linear regression to test associations of DPs with AHEI-2010 and years living in the US. This trial was registered at clinicaltrials.gov as NCT02060344. Results We identified 5 overarching DPs (“Burgers, Fries, & Soft Drinks”; “White Rice, Beans, & Red Meats”; “Fish”; “Egg & Cheese”; and “Alcohol”). While all “Burgers, Fries, & Soft Drinks” DPs were inversely associated with AHEI-2010, all Fish DPs (except Dominican) were positively associated with this index (all Ptrend &lt; 0.001). Meanwhile, “White Rice, Beans, & Red Meats” DPs showed inverse associations in Cuban and Central American groups and positive associations in Mexican-origin individuals (all Ptrend &lt; 0.001). Fewer years living in the US was associated with higher scores for “White Rice, Beans, & Red Meats” DPs in Cuban and Mexican heritage groups and lower scores on “Burgers, Fries, & Soft Drinks” DPs in Cuban, Mexican, and Puerto Rican groups (all Ptrend &lt; 0.01). Conclusions Our findings show substantial variation in DPs across Hispanics/Latinos and adherence in DPs by time in the US, which could inform dietary interventions targeting this diverse US population. Funding Sources This research received support from the National Heart, Lung, and Blood Institute Global Cardiometabolic Disease Training Grant (1T32HL129969–01A1), the National Institute of Diabetes and Digestive and Kidney Diseases (K01DK107791), and from the Population Research Infrastructure Program (R24 HD050924) awarded to the Carolina Population Center at The University of North Carolina at Chapel Hill by the Eunice Kennedy Shriver National Institute of Child Health and Human Development.


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