American Journal of Epidemiology Vol. 144, No. 11: 1058-1065
Copyright © 1996 by The Johns Hopkins University School of Hygiene and Public Health
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Effects of Cigarette Smoking, Diabetes, High Cholesterol, and Hypertension on All-Cause Mortality and Cardiovascular Disease Mortality in Mexican Americans
The San Antonio Heart Study
1Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio San Antonio, TX
2Department of Genetics, Southwest Foundation for Biomedical Research San Antonio, TX
Reprint requests to Dr. Ming Wei, Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX 78284
Despite high levels of cardiovascular risk factors, Mexican Americans paradoxically have a lower prevalence of cardiovascular disease. A possible explanation is that conventional cardiovascular risk factors have a lesser impact on this ethnic group. In the present study, a 7- to 8-year follow-up of the San Antonio Heart Study cohort was used to estimate total and cardiovascular disease mortality and their association with baseline risk factors. A total of 2,629 Mexican Americans form the basis of this study, and 1,136 non-Hispanic whites from the same cohort served as the comparison group. The age- and sex-adjusted rates for total death and cardiovascular disease death were somewhat higher in Mexican Americans than non-Hispanic whites (rate ratio for total mortality = 1.4,95% confidence interval 1.0–2.0; and rate ratio for cardiovascular mortality = 1.3,95% confidence interval 0.7–2.4). After adjustment for sex, age, and socioeconomic status in multivariate analyses, current smoking, diabetes, high cholesterol, and hypertension were positively associated with all-cause mortality and cardiovascular disease mortality in Mexican Americans. Overall, these risk factors accounted for 45% of all-cause mortality and 55% of cardiovascular disease mortality in this ethnic group. In comparison, the risk factors accounted for 46% of all-cause mortality and 46% of cardiovascular disease mortality in non-Hispanic whites. The authors conclude that cigarette smoking, diabetes, high cholesterol, and hypertension are important predictors of both all-cause and cardiovascular disease deaths in Mexican Americans. There was no evidence for a diminished effect of these risk factors in Mexican Americans. Am J Epidemiol 1996;144:1058-65.
cardiovascular diseases; cohort studies; Mexican Americans; mortality; risk factors; whites
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