High Rates of Heart Failure Among Hispanics/Latinos Go Unrecognized

According to recent research, Latino-Americans have high rates of cardiac dysfunction with a high prevalence of diastolic dysfunction, but these issues are overwhelmingly unrecognized.

The Latino/Hispanic population has high rates of diabetes, obesity, and high blood pressure, all of which may lead to cardiac dysfunction and, ultimately, heart failure. However, few studies have focused on this group and the only other large study of cardiac dysfunction within the US looked at older, largely non-Hispanic white adults and, perhaps due to this oversight, Latino/Hispanics have often been considered at low risk for cardiac dysfunction.

The Echocardiographic Study of Latinos (ECHO-SOL), published in Circulation: Heart Failure, evaluated 1818 adults of Hispanic/Latino origin aged 45 to 74 years from the Bronx, Chicago, Miami, and San Diego. Many of those at risk for cardiac dysfunction were obese, had high blood pressure, had diabetes, and/or reported low levels of physical activity. Approximately 20% were current smokers.

The project identified 2 types of cardiac dysfunction: left ventricular systolic dysfunction (LVSD) and left ventricular diastolic dysfunction (LVDD). In LVSD the left ventricle does not push blood as forcibly as it should; in LVDD the left ventricle is too stiff in between beats and cannot gather enough blood.

About 49.7% of adults evaluated had LVSD, LVDD, or both. Prevalence of LVSD was 3.6% while prevalence of LVDD was 50.3%. Prevalence of clinical heart failure with LVSD was 7.3% and 3.6% for those with LVDD; clinical heart failure was self-reported.

Those with LVSD were more frequently male and current smokers. Those with LVDD were more frequently female, had hypertension, had diabetes mellitus, had higher BMIs, and had renal dysfunction. Rates of LVDD were higher among Latino-Americans with Central American and Cuban backgrounds.

However, 96.1% of adults with cardiac dysfunction did not realize that they had this problem.

Carlos J. Rodriguez, MD, MPH, study senior author and associate professor of medicine and epidemiology at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina, said that health professionals should have a high level of vigilance when monitoring patients of Hispanic/Latino origins, and a low threshold for intensifying preventative therapies in order to avoid future heart failure.

Due to lack of previous research, there are no reliable estimates for how many patients with cardiac dysfunction will develop heart failure later on. Researchers plan to continue tracking ECHO-SOL participants.

“Given that Hispanics/Latinos are the largest ethnic minority in the United States, with over 51 million people, they are likely to have a big impact on the heart failure epidemic,” Dr Rodriguez said in a statement.