By Olveen Carrasquillo, University of Miami
The Research Brief is a brief look at interesting academic work.
the big idea
Latinos may have more heart disease than previously thought, disproving a widely accepted idea known as the “Latino paradox,” according to a new study I was involved in.
The gist of the Latino paradox is this: A wide body of research shows that Latinos are more likely to have diabetes, obesity, and uncontrolled blood pressure and cholesterol levels than non-Hispanic whites. So it would naturally follow that Latino people should also have higher levels of cardiovascular disease.
But over the past 30 years, a large body of research has shown the opposite: Despite greater risk factors for heart disease, Latinos have a lower death rate from heart disease than non-Latinos.
However, we found that both Latino men and women have significantly higher rates of heart disease than non-Hispanic whites. In fact, in men, we found the rate of heart disease that was even slightly higher than in black people, a group with the highest rates of heart disease. We found that 9.2% of Latinos were diagnosed with heart disease, compared with 8.1% among black people and 7.6% among non-Hispanic white men.
To conduct the analysis, we used data from the All of Us research program, which aims to enroll at least 1 million people from diverse backgrounds over the next few years. We examined medical records of the more than 200,000 people who have already signed up for the program, including more than 40,000 Latinos.
When we went into the study, we assumed we would find evidence to support the Latino paradox. Previous data on the paradox have been based primarily on death rates or self-reporting, both of which have inherent limitations. For example, without an autopsy it is often difficult to know for sure what led to someone’s death. People may also not be aware that they have heart disease, especially if they haven’t seen a doctor for a long time.
Instead, in our work, we looked at medical records and examined diagnoses of heart disease as diagnosed by a physician during health care visits. We think this is a new approach as more robust data is being used to investigate this issue.
Why it matters
The widely accepted “Latino paradox” has been extensively studied. And so far, most studies have supported this, although none have found a concrete explanation for it. Medical and public health students are often taught about it as an inexplicable phenomenon. But our study, which used the largest research cohort of Latinos in the United States, seems to refute the paradox.
The implications are crucial because they suggest that Latinos, like all other groups, should still support themselves by eating a healthy diet, exercising regularly, watching their weight, avoiding smoking and getting regular checkups. Those with diabetes, hypertension or cholesterol should make sure that these conditions are well controlled.
These seemingly straightforward messages are the ones that doctors have been telling all their patients for decades. Still, this study makes it clear that Latinos don’t get a free pass when it comes to heart disease and that they also have to follow health guidelines. And our study highlights the ongoing need for culturally tailored cardiovascular health programs for the Latino community.
What is still unknown
While our study analyzed data from the largest existing cohort of Latinos, we don’t think ours is the definitive word on the subject. More research is needed, and we need to keep thinking creatively about how to get to these questions. It is also important to keep in mind that Latino populations are not homogeneous. Latinos come from many different parts of Latin America, where diets, customs and lifestyles are all unique.
That’s why our team is interested in looking at health data focused on Latino subgroups, and comparing US-born Latinos to immigrants. We also hope to explore the Latino paradox when it comes to other conditions like cancer, which research has also shown to be less common in Latinos than other groups. That’s another paradox that we need to reexamine.
Olveen Carrasquillo, professor of medicine and public health sciences, University of Miami
This article is republished from The Conversation under a Creative Commons license. Read the original article.