Cardiovascular risk factor variation within a hispanic cohort: SWAN, the study of women's health across the nation

Objectives: Hispanics have less favorable cardiovascular risk profiles relative to other groups, although little is known regarding variability in risk profiles according to country of origin. Our goal was to examine the association of cardiovascular risk factors with country of origin and acculturation in a cohort of middle-aged Hispanic women. Design: Cross-sectional study. Setting: Baseline data for participants at the New Jersey Site of the Study of Women's Health Across the Nation (SWAN). Participants: 419 women, aged 42-52 years, comprising 142 non-Hispanic Whites and 277 Hispanic: Central American (n=29), South American (n=106), Puerto Rican (n556), Dominican (n=42) and Cuban (n=44). Main Outcome Measures: BMI, smoking, blood pressure, lipid profiles, and presence of hypertension, hyperlipidemia, diabetes and metabolic syndrome were compared using univariate and multivariable models. Results: LDL and HDL varied significantly across Hispanic subgroups (overall P≤.05). Prevalence of metabolic syndrome was greatest in Puerto Rican women (48.2% vs 40.0%, 35.0%, 13.9% and 29.3% in Central American, South American, Dominican and Cuban women, respectively, P=.016). Central American women were least likely to smoke (P<.05 vs Puerto Rican, Cuban and South American). Prevalence of hypertension and diabetes were similar across groups. Differences in lipids and metabolic syndrome were not explained by acculturation, financial strain, education, physical activity, smoking or dietary fat intake. Conclusions: There is significant heterogeneity in cardiovascular risk status among middleaged Puerto Rican, Cuban, Dominican, Central American and South American women, not explained by acculturation or socioeconomic indicators. These differences may be important for targeting screening and preventive interventions.