Am J Epidemiol 2002; 156:919-928.
Copyright © 2002 by Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Cardiovascular Disease Mortality in Hispanics and Non-Hispanic Whites
1 Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO.
2 Miami-Dade County Health Department, Miami, FL.
3 Barbara Davis Center for Childhood Diabetes, Denver, CO.
4 Department of Medicine, Divisions of Geriatrics and Cardiology, Section of Vascular Medicine and the Colorado Prevention Center, University of Colorado Health Sciences Center, Denver, CO.
Despite a worse cardiovascular disease (CVD) risk profile, Hispanics have lower CVD mortality than non-Hispanic Whites in studies based on death certificates. This study examined 310 deaths that occurred between 1984 and 1998 among 1,862 Hispanic and non-Hispanic White participants in the San Luis Valley Diabetes Study, using medical records to classify cause of death. Among persons without diabetes, the age-adjusted all-cause mortality rate was 6.1/1,000 person-years in non-Hispanic Whites and 7.4/1,000 person-years in Hispanics. Among persons with diabetes, it was 24.3/1,000 person-years in non-Hispanic Whites and 21.9/1,000 person-years in Hispanics. Among nondiabetics, the age-adjusted CVD mortality rate was 2.5/1,000 person-years in non-Hispanic Whites and 1.6/1,000 person-years in Hispanics. Among diabetics, it was 12.9/1,000 person-years in non-Hispanic Whites and 8.8/1,000 person-years in Hispanics. Among nondiabetics, the adjusted hazard ratio for CVD death in Hispanics compared with non-Hispanic Whites was 0.65 (95% confidence interval (CI): 0.34, 1.23). The hazard ratio for coronary heart disease death was 0.95 (95% CI: 0.35, 2.59). Among diabetics, the hazard ratio for CVD death, after adjustment for conventional and diabetes risk factors, was 0.44 (95% CI: 0.26, 0.74), and for coronary heart disease death it was 0.43 (95% CI: 0.21, 0.91). A statistically significant decreased risk of CVD death was observed only in male Hispanics with diabetes. Competing mortality or factors that interact with diabetes may explain these differences.
cardiovascular diseases; diabetes mellitus; Hispanic Americans; mortality; risk factors
Abbreviations: Abbreviations: CI, confidence interval; HDL, high density lipoprotein; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; LDL, low density lipoprotein.
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