Coronary Death and Myocardial Infarction among Hispanics in the Northern Manhattan Study: Exploring the Hispanic Paradox

Joshua Z. Willey, Carlos J. Rodriguez, Yeseon Park Moon, Myunghee C. Paik, Marco R. Di Tullio, Shunichi Homma, Ralph L Sacco, Mitchell S V Elkind

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)303-309
Number of pages7
JournalAnnals of Epidemiology
Volume22
Issue number5
DOIs
StatePublished - May 1 2012

Fingerprint

Hispanic Americans
Myocardial Infarction
Blood Vessels
Confidence Intervals
Cardiovascular Diseases
Proportional Hazards Models
Demography
Exercise
Hypertension
Mortality

Keywords

  • Cardiovascular Disease
  • Hispanic
  • Mortality
  • Paradox

ASJC Scopus subject areas

  • Epidemiology

Cite this

Willey, J. Z., Rodriguez, C. J., Moon, Y. P., Paik, M. C., Di Tullio, M. R., Homma, S., ... Elkind, M. S. V. (2012). Coronary Death and Myocardial Infarction among Hispanics in the Northern Manhattan Study: Exploring the Hispanic Paradox. Annals of Epidemiology, 22(5), 303-309. https://doi.org/10.1016/j.annepidem.2012.02.014

Coronary Death and Myocardial Infarction among Hispanics in the Northern Manhattan Study : Exploring the Hispanic Paradox. / Willey, Joshua Z.; Rodriguez, Carlos J.; Moon, Yeseon Park; Paik, Myunghee C.; Di Tullio, Marco R.; Homma, Shunichi; Sacco, Ralph L; Elkind, Mitchell S V.

In: Annals of Epidemiology, Vol. 22, No. 5, 01.05.2012, p. 303-309.

Research output: Contribution to journalArticle

Willey, Joshua Z. ; Rodriguez, Carlos J. ; Moon, Yeseon Park ; Paik, Myunghee C. ; Di Tullio, Marco R. ; Homma, Shunichi ; Sacco, Ralph L ; Elkind, Mitchell S V. / Coronary Death and Myocardial Infarction among Hispanics in the Northern Manhattan Study : Exploring the Hispanic Paradox. In: Annals of Epidemiology. 2012 ; Vol. 22, No. 5. pp. 303-309.
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AU - Paik, Myunghee C.

AU - Di Tullio, Marco R.

AU - Homma, Shunichi

AU - Sacco, Ralph L

AU - Elkind, Mitchell S V

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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.

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KW - Mortality

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