Posted on 09/18/2009 8:47:58 PM PDT by neverdem
CHICAGO — Although Hispanics are grossly underrepresented in heart failure trials, emerging evidence suggests they have unique risk factors and heart failure outcomes that must be taken into clinical consideration.
The evidence also underscores the importance of recognizing the vast heterogeneity of Hispanics, Dr. Ileana Piña said at a meeting sponsored by the International Society on Hypertension in Blacks.
“Hispanics represent a cultural group, not a racially identifiable group,” said the Cuban-born cardiologist. “You can't lump them all together.”
But that's exactly what has happened. Until the Medicare enrollment files were changed in 1994, Hispanics or Native Americans were simply classified as either “white” or “black.” It wasn't until the 2000 U.S. census that the term “Hispanic” was changed to “Spanish, Hispanic, or Latino” to describe persons of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture or origin, regardless of race.
Several studies have made the observation—coined the “Hispanic paradox”—that Hispanics have lower all-cause and cardiovascular mortality, despite increased obesity and diabetes, and lower socioeconomic status, said Dr. Piña, professor of medicine at Case Western Reserve University in Cleveland, and a Veterans Affairs National Quality Scholar.
A study of Medicare enrollees aged 65 years or older found that Hispanics were 1.2 times more likely to be hospitalized for heart failure than were whites, while blacks were 1.5 times more likely. But after adjustment for sex and age, in-hospital mortality was significantly lower among Hispanics and blacks than among whites (Am. Heart J. 2005;150:448-54).
Sociocultural factors are often used to explain the Hispanic paradox, but more recent data are causing some to rethink the paradox or at least to differentiate Hispanics by birthplace. Among diabetics in the San Antonio Heart Study, age- and sex-adjusted hazard ratios indicated that U.S.-born Mexican Americans have a 66% greater risk of all-cause mortality and of cardiovascular mortality, compared with non-Hispanic whites, while Mexico-born Mexican Americans appeared to be at similar risk (Diabetes Care 2002;25:1557-63).
A recently published “state-of-the-art” paper on the subject notes that Hispanic ethnicity is marked by a disproportionate cardiometabolic risk burden, largely because of exceedingly high rates of insulin resistance. The authors hypothesize that “the central concept of insulin resistance—compounded by inflammation and neuroendocrine overactivity—may be a predominant etiologic factor for cardiomyopathy in Hispanics” (J. Am. Coll. Cardiol. 2009;53;1167-75).
The authors called for greater representation in patient registries, research studies, and clinical trials, a call echoed by Dr. Piña. She noted that Hispanic or Latino patients made up just 3% of HF-ACTION (Heart Failure: A Controlled Trial Investigating Outcomes of Exercise Training), even though they make up about 15% of the total U.S. population. Still, among nine other recent heart failure trials, it was the only one to specifically differentiate Hispanics, instead of lumping them together with other ethnicities as “nonwhites” or “other.”
Dr. Piña disclosed serving as a speaker for AstraZeneca, Novartis, and Merck, and as a consultant for the Food and Drug Administration.
So exactly who is an Hispanic?
Why haven’t Fidel or Hugo already done this “study”? Don’t they care about Hispanics?
I’d be looking at the waist to hip ratio. Hispanics in my area are nearly all originally from Mexico and most have no waists, even the young girls.
Maybe diet has a roll here.
really.
Ive seen a lot of Latinas with wide hips
*shakes hips*
lol!!!
Yep....a lot of corn, flour, beans....puts on the pounds....plus add in junk food, etc.....if they ate PALEO, they’d probably not have the problems.
Many Latinos tell me recollections about mothers and grandmothers cooking routinely with large tubs of lard by the stove. They would heave large handfuls of it for nearly everything.
There’s no such thing as a Hispanic — an Argentian of Itaklian descent, a Brazilian of German descent, a Peruvian of aboriginal descent,a Mexican of Aztec descent, a Cuban of African descent, and all the admixtures of the above with people of different regions of Spain have nothing in common aside from speaking Spanish.
I call myself an Hispanic by proxy because I married into a Latin family, and I speak Spanish. So, I'm Hispanic enough to comment. :)
For one thing, the traditional definition of "Hispanic" referred to someone from Spain or Portugal. "Latin" means someone from this side of the world. Those distinctions died, I suppose.
I've been in about every corner of Mexico, and you're right, most of the Mexican women are pretty round. That's a combination of Indian genetics and overindulging on the finest food this planet has to offer. I can't blame them, but I wish they wouldn't wear the Spandex.
Most of the Mexicans you see here have a lot of Indian blood because of discrimination in Mexico. (Imagine that: Hispaniscs discriminate! I thought it was just white Americans!) In Mexico, there is more diversity, and some of the women are quite shapely and attractive. Given the Latin mindset, they easily find jobs in Mexico. :)
My wife is not Mexican, and she's quite thin. Generally, you'll find that the women are thinner from Costa Rica down to Argentina. I've been to Spain a lot, and I have to say that the women there tend to have fantastic waists till about age 50. It's the same in Italy.
Agreed but many have largely assimilated and eat pretty much what we do. My DIL is of Mexican heritage, she’s thin, she’s in shape, she’s still thick in the middle.
I just got home from a football game and was thinking that the cheerleader’s uniforms fit badly and realized that they were really cute on the 4 girls that had waists and that was the 2 white girls, the black girl and my granddaughter, there were about 18 girls with 14 of them being of full Mexican heritage and even the anorexic looking one didn’t have a waist.
I agree with you. This is an artificial group that was created by the Dems in the 1970s to have another class of victims, including whites. 54% of Hispanics self-describe as whites.
It’s so annoying for me, working in media & entertainment when idiot gringos talk about the “Latino market” or the Hisoanic market” and I have to continually explain that there is no such thing.
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