Statin and aspirin use among hispanic and latino adults at high cardiovascular risk: Findings from the hispanic community health study/study of latinos

Dima M. Qato, Todd A. Lee, Ramon Durazo-Arvizu, Donghong Wu, Jocelyn Wilder, Samantha A. Reina, Jianwen Cai, Franklyn Gonzalez, Gregory A. Talavera, Robert J Ostfeld, Martha L. Daviglus

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background-Despite variations in the prevalence of cardiovascular disease and related risk factors among US Hispanic/Latino adults of diverse backgrounds, there is little information on whether disparities exist in the use of medications for the primary and secondary prevention of cardiovascular disease. We examined the prevalence of statin and aspirin use among diverse US Hispanic/Latino adults at high cardiovascular risk. Methods and Results-A multicenter population-based study, the Hispanic Community Health Study/Study Of Latinos, included a total of 16 415 participants of Mexican, Puerto Rican, Cuban, Dominican, South American, and Central American backgrounds who were aged 18 to 74 years and enrolled between March 2008 and June 2011. Our analyses were limited to 4139 participants considered to be at high cardiovascular risk. Age-adjusted prevalence of statin and aspirin use was 25% and 44%, respectively, overall but varied by Hispanic/Latino background among those at high cardiovascular risk; statin use was significantly higher (P<0.001) among adults of Puerto Rican (33%) and Dominican (28%) backgrounds compared with adults of other backgrounds (Mexican, 24%; Cuban, 22%; Central American, 20%; South American, 22%). There was no difference in aspirin use. After adjusting for health insurance coverage, the difference in prevalence of statin use was substantially reduced among participants with a Puerto Rican background, from an odds ratio of 1.73 (95% CI 1.30-2.31) to 1.30 (95% CI 0.97-1.75), and with a Dominican background, from an odds ratio of 1.45 (95% CI 1.04-2.02) to 1.07 (95% CI 0.75-1.52), in comparison to their counterparts. Conclusions-Among Hispanic/Latino adults of diverse backgrounds, statin use was more prevalent among adults with Puerto Rican and Dominican backgrounds at high cardiovascular risk. These differences in statin use were explained, in part, by differences in insurance coverage. These findings have important implications for the prevention of disparities in cardiovascular outcomes within the growing US Hispanic/Latino population.

Original languageEnglish (US)
Article numbere002905
JournalJournal of the American Heart Association
Volume5
Issue number4
DOIs
StatePublished - 2016

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Hydroxymethylglutaryl-CoA Reductase Inhibitors
Hispanic Americans
Aspirin
Health
Insurance Coverage
Cardiovascular Diseases
Odds Ratio
Primary Prevention
Health Insurance
Secondary Prevention
Population

Keywords

  • Cardiovascular risk
  • Disparities
  • Hispanic/Latino
  • Statins

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Statin and aspirin use among hispanic and latino adults at high cardiovascular risk : Findings from the hispanic community health study/study of latinos. / Qato, Dima M.; Lee, Todd A.; Durazo-Arvizu, Ramon; Wu, Donghong; Wilder, Jocelyn; Reina, Samantha A.; Cai, Jianwen; Gonzalez, Franklyn; Talavera, Gregory A.; Ostfeld, Robert J; Daviglus, Martha L.

In: Journal of the American Heart Association, Vol. 5, No. 4, e002905, 2016.

Research output: Contribution to journalArticle

Qato, Dima M. ; Lee, Todd A. ; Durazo-Arvizu, Ramon ; Wu, Donghong ; Wilder, Jocelyn ; Reina, Samantha A. ; Cai, Jianwen ; Gonzalez, Franklyn ; Talavera, Gregory A. ; Ostfeld, Robert J ; Daviglus, Martha L. / Statin and aspirin use among hispanic and latino adults at high cardiovascular risk : Findings from the hispanic community health study/study of latinos. In: Journal of the American Heart Association. 2016 ; Vol. 5, No. 4.
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abstract = "Background-Despite variations in the prevalence of cardiovascular disease and related risk factors among US Hispanic/Latino adults of diverse backgrounds, there is little information on whether disparities exist in the use of medications for the primary and secondary prevention of cardiovascular disease. We examined the prevalence of statin and aspirin use among diverse US Hispanic/Latino adults at high cardiovascular risk. Methods and Results-A multicenter population-based study, the Hispanic Community Health Study/Study Of Latinos, included a total of 16 415 participants of Mexican, Puerto Rican, Cuban, Dominican, South American, and Central American backgrounds who were aged 18 to 74 years and enrolled between March 2008 and June 2011. Our analyses were limited to 4139 participants considered to be at high cardiovascular risk. Age-adjusted prevalence of statin and aspirin use was 25{\%} and 44{\%}, respectively, overall but varied by Hispanic/Latino background among those at high cardiovascular risk; statin use was significantly higher (P<0.001) among adults of Puerto Rican (33{\%}) and Dominican (28{\%}) backgrounds compared with adults of other backgrounds (Mexican, 24{\%}; Cuban, 22{\%}; Central American, 20{\%}; South American, 22{\%}). There was no difference in aspirin use. After adjusting for health insurance coverage, the difference in prevalence of statin use was substantially reduced among participants with a Puerto Rican background, from an odds ratio of 1.73 (95{\%} CI 1.30-2.31) to 1.30 (95{\%} CI 0.97-1.75), and with a Dominican background, from an odds ratio of 1.45 (95{\%} CI 1.04-2.02) to 1.07 (95{\%} CI 0.75-1.52), in comparison to their counterparts. Conclusions-Among Hispanic/Latino adults of diverse backgrounds, statin use was more prevalent among adults with Puerto Rican and Dominican backgrounds at high cardiovascular risk. These differences in statin use were explained, in part, by differences in insurance coverage. These findings have important implications for the prevention of disparities in cardiovascular outcomes within the growing US Hispanic/Latino population.",
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author = "Qato, {Dima M.} and Lee, {Todd A.} and Ramon Durazo-Arvizu and Donghong Wu and Jocelyn Wilder and Reina, {Samantha A.} and Jianwen Cai and Franklyn Gonzalez and Talavera, {Gregory A.} and Ostfeld, {Robert J} and Daviglus, {Martha L.}",
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T1 - Statin and aspirin use among hispanic and latino adults at high cardiovascular risk

T2 - Findings from the hispanic community health study/study of latinos

AU - Qato, Dima M.

AU - Lee, Todd A.

AU - Durazo-Arvizu, Ramon

AU - Wu, Donghong

AU - Wilder, Jocelyn

AU - Reina, Samantha A.

AU - Cai, Jianwen

AU - Gonzalez, Franklyn

AU - Talavera, Gregory A.

AU - Ostfeld, Robert J

AU - Daviglus, Martha L.

PY - 2016

Y1 - 2016

N2 - Background-Despite variations in the prevalence of cardiovascular disease and related risk factors among US Hispanic/Latino adults of diverse backgrounds, there is little information on whether disparities exist in the use of medications for the primary and secondary prevention of cardiovascular disease. We examined the prevalence of statin and aspirin use among diverse US Hispanic/Latino adults at high cardiovascular risk. Methods and Results-A multicenter population-based study, the Hispanic Community Health Study/Study Of Latinos, included a total of 16 415 participants of Mexican, Puerto Rican, Cuban, Dominican, South American, and Central American backgrounds who were aged 18 to 74 years and enrolled between March 2008 and June 2011. Our analyses were limited to 4139 participants considered to be at high cardiovascular risk. Age-adjusted prevalence of statin and aspirin use was 25% and 44%, respectively, overall but varied by Hispanic/Latino background among those at high cardiovascular risk; statin use was significantly higher (P<0.001) among adults of Puerto Rican (33%) and Dominican (28%) backgrounds compared with adults of other backgrounds (Mexican, 24%; Cuban, 22%; Central American, 20%; South American, 22%). There was no difference in aspirin use. After adjusting for health insurance coverage, the difference in prevalence of statin use was substantially reduced among participants with a Puerto Rican background, from an odds ratio of 1.73 (95% CI 1.30-2.31) to 1.30 (95% CI 0.97-1.75), and with a Dominican background, from an odds ratio of 1.45 (95% CI 1.04-2.02) to 1.07 (95% CI 0.75-1.52), in comparison to their counterparts. Conclusions-Among Hispanic/Latino adults of diverse backgrounds, statin use was more prevalent among adults with Puerto Rican and Dominican backgrounds at high cardiovascular risk. These differences in statin use were explained, in part, by differences in insurance coverage. These findings have important implications for the prevention of disparities in cardiovascular outcomes within the growing US Hispanic/Latino population.

AB - Background-Despite variations in the prevalence of cardiovascular disease and related risk factors among US Hispanic/Latino adults of diverse backgrounds, there is little information on whether disparities exist in the use of medications for the primary and secondary prevention of cardiovascular disease. We examined the prevalence of statin and aspirin use among diverse US Hispanic/Latino adults at high cardiovascular risk. Methods and Results-A multicenter population-based study, the Hispanic Community Health Study/Study Of Latinos, included a total of 16 415 participants of Mexican, Puerto Rican, Cuban, Dominican, South American, and Central American backgrounds who were aged 18 to 74 years and enrolled between March 2008 and June 2011. Our analyses were limited to 4139 participants considered to be at high cardiovascular risk. Age-adjusted prevalence of statin and aspirin use was 25% and 44%, respectively, overall but varied by Hispanic/Latino background among those at high cardiovascular risk; statin use was significantly higher (P<0.001) among adults of Puerto Rican (33%) and Dominican (28%) backgrounds compared with adults of other backgrounds (Mexican, 24%; Cuban, 22%; Central American, 20%; South American, 22%). There was no difference in aspirin use. After adjusting for health insurance coverage, the difference in prevalence of statin use was substantially reduced among participants with a Puerto Rican background, from an odds ratio of 1.73 (95% CI 1.30-2.31) to 1.30 (95% CI 0.97-1.75), and with a Dominican background, from an odds ratio of 1.45 (95% CI 1.04-2.02) to 1.07 (95% CI 0.75-1.52), in comparison to their counterparts. Conclusions-Among Hispanic/Latino adults of diverse backgrounds, statin use was more prevalent among adults with Puerto Rican and Dominican backgrounds at high cardiovascular risk. These differences in statin use were explained, in part, by differences in insurance coverage. These findings have important implications for the prevention of disparities in cardiovascular outcomes within the growing US Hispanic/Latino population.

KW - Cardiovascular risk

KW - Disparities

KW - Hispanic/Latino

KW - Statins

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