TY - JOUR
T1 - Coronary Death and Myocardial Infarction among Hispanics in the Northern Manhattan Study
T2 - Exploring the Hispanic Paradox
AU - Willey, Joshua Z.
AU - Rodriguez, Carlos J.
AU - Moon, Yeseon Park
AU - Paik, Myunghee C.
AU - Di Tullio, Marco R.
AU - Homma, Shunichi
AU - Sacco, Ralph L.
AU - Elkind, Mitchell S.V.
N1 - Funding Information:
Funding: This project was supported by NINDS R37 NS29993 . J.Z.W. was funded by NINDS 1K23 NS073104-01A1 .
PY - 2012/5
Y1 - 2012/5
N2 - Purpose: Prior studies have reported that Hispanics have lower cardiovascular disease (CVD) mortality despite a higher burden of risk factors. We examined whether Hispanic ethnicity was associated with a lower risk of nonfatal myocardial infarction (MI) coronary death (CD) and vascular death. Methods: A total of 2671 participants in the Northern Manhattan Study without clinical CVD were prospectively evaluated. Cox models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association of race-ethnicity with nonfatal MI, CD, and vascular death after adjusting for demographic and CVD risk factors. Results: Mean age was 68.8 (10.4) years; 52.8% were Hispanic (88% Caribbean-Hispanic). Hispanics were more likely to have hypertension (73.1% vs. 62.2%, p < .001) and diabetes (22.0% vs. 13.3%, p < .001), and less likely to perform any physical activity (50.1% vs. 69.2%, p < .001) compared to non-Hispanic whites (NHW). During a mean 10 years of follow-up there were 154 nonfatal MIs, 186 CD, and 386 vascular deaths. In fully adjusted models, Hispanics had a lower risk of CD (adjusted HR = 0.36, 95% CI: 0.21-0.60), and vascular death (adjusted HR = 0.62, 95% CI: 0.43-0.89), but not nonfatal MI (adjusted HR = 0.95, 95% CI: 0.56-1.60) when compared to NHW. Conclusions: We found a "Hispanic paradox" for coronary and vascular deaths, but not nonfatal MI.
AB - Purpose: Prior studies have reported that Hispanics have lower cardiovascular disease (CVD) mortality despite a higher burden of risk factors. We examined whether Hispanic ethnicity was associated with a lower risk of nonfatal myocardial infarction (MI) coronary death (CD) and vascular death. Methods: A total of 2671 participants in the Northern Manhattan Study without clinical CVD were prospectively evaluated. Cox models were used to calculate hazard ratios (HR) and 95% confidence intervals (CI) for the association of race-ethnicity with nonfatal MI, CD, and vascular death after adjusting for demographic and CVD risk factors. Results: Mean age was 68.8 (10.4) years; 52.8% were Hispanic (88% Caribbean-Hispanic). Hispanics were more likely to have hypertension (73.1% vs. 62.2%, p < .001) and diabetes (22.0% vs. 13.3%, p < .001), and less likely to perform any physical activity (50.1% vs. 69.2%, p < .001) compared to non-Hispanic whites (NHW). During a mean 10 years of follow-up there were 154 nonfatal MIs, 186 CD, and 386 vascular deaths. In fully adjusted models, Hispanics had a lower risk of CD (adjusted HR = 0.36, 95% CI: 0.21-0.60), and vascular death (adjusted HR = 0.62, 95% CI: 0.43-0.89), but not nonfatal MI (adjusted HR = 0.95, 95% CI: 0.56-1.60) when compared to NHW. Conclusions: We found a "Hispanic paradox" for coronary and vascular deaths, but not nonfatal MI.
KW - Cardiovascular Disease
KW - Hispanic
KW - Mortality
KW - Paradox
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U2 - 10.1016/j.annepidem.2012.02.014
DO - 10.1016/j.annepidem.2012.02.014
M3 - Article
C2 - 22424967
AN - SCOPUS:84860248895
SN - 1047-2797
VL - 22
SP - 303
EP - 309
JO - Annals of Epidemiology
JF - Annals of Epidemiology
IS - 5
ER -
