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 Scopus citations

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

Keywords

  • Cardiovascular Disease
  • Hispanic
  • Mortality
  • Paradox

ASJC Scopus subject areas

  • Epidemiology

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