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AHA encourages culturally tailored heart care for Hispanic patients
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A new scientific statement from the American Heart Association suggests culturally tailored approaches to counseling US Hispanic patients on heart care.
The statement, written by members of three AHA councils, also documents the status of CVD knowledge among Hispanics and discusses sociocultural issues that affect Hispanics with regard to CV health.
“This segment of the population has been somewhat ignored,” Carlos J. Rodriguez, MD, MPH, FAHA, chair of the writing group and associate professor of medicine and epidemiology at Wake Forest Baptist Medical Center, Winston-Salem, N.C., said in a press release. “Given the large Hispanic population in the US, it would be very hard to improve the health of the nation if this population is left behind.”
Carlos J. Rodriguez
The writing group noted that most literature on US Hispanics and CVD is focused on Mexican Americans, whereas other Hispanic populations, including those with origins in Cuba, Puerto Rico, the Dominican Republic, Central America and South America, are underrepresented in clinical research. “There is still a lot that we don’t know about [CV] risk and disease in the many other Hispanic populations,” Rodriguez said in the release.
The writing group noted that Hispanics are less aware of CV risk factors compared with non-Hispanic whites.
Differences in CV health
The group highlighted several differences in CV health factors between Hispanics and non-Hispanics, including:
- Hispanics are twice as likely to be diagnosed with type 2 diabetes as non-Hispanic whites.
- Hispanic youths have a higher rate of smoking compared with non-Hispanic white youths (28% vs. 23.7%). However, the overall prevalence of smoking is lower among US Hispanics than US non-Hispanic whites or non-Hispanic blacks, and smoking among certain Hispanic subgroups nears or exceeds the national average.
- Preschool-age Hispanic children are four times more likely to be obese compared with non-Hispanic white children.
- Mexican Americans are more likely to be hospitalized for MI compared with non-Hispanic whites.
- Mexican Americans are twice as likely to have an ischemic stroke before age 60 years compared with non-Hispanic whites.
The writing group called for health care providers to be trained in providing culturally proficient care to Hispanic patients; for health research, electronic health records and other surveillance systems to include Hispanic subgroups based on country of origin; for more Spanish-speaking health care workers, including physicians, to be hired; for the creation of educational programs geared toward alerting Hispanics to risk factors and warning signs for stroke and MI; and for the implementation of effective heart health promotion and disease prevention strategies in Hispanic communities and schools.
The ‘Hispanic paradox’
The group also called for more research assessing the “Hispanic paradox,” observed in prior studies, which suggested that Hispanics have lower rates of overall and CV-related mortality than non-Hispanic whites despite a poor CV risk profile. The paradox “highlights how little we know about Hispanics” and “needs to be evaluated for all the leading causes of Hispanic morbidity and mortality,” as well as assessed across all Hispanic subgroups, the authors wrote.
The authors made many culturally relevant recommendations, including involving family members as much as possible in decisions regarding a patient, being aware that some medical terms lack a direct translation into Spanish, attempting direct communication with the patient even with imperfect Spanish, and understanding that cultural traits of politeness and respect may not necessarily imply satisfaction with treatment recommendations or interest in adhering to treatment.
Disclosure: See the full statement for the writing group members’ relevant financial disclosures.
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