Am J Epidemiol 2003; 158:1048-1057.
Copyright © 2003 by the Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
All-Cause and Cardiovascular Mortality among Mexican-American and Non-Hispanic White Older Participants in the San Antonio Heart Study— Evidence against the "Hispanic Paradox"
From the Division of Clinical Epidemiology, Department of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX.
The observation that Hispanics have lower all-cause and cardiovascular mortality rates despite increased rates of diabetes and obesity and lower socioeconomic status has been termed the "Hispanic paradox." The authors therefore examined the relation between ethnicity and mortality in 1,438 Mexican-American and 921 non-Hispanic White San Antonio Heart Study participants, aged 45–64 years when they enrolled between 1979 and 1988. Over an average of 14.5 years, 466 deaths occurred: 238 attributed to cardiovascular disease (death certificate International Classification of Diseases, Ninth Revision, codes 401–414 or codes 420–447 with the exception of code 427.5) and 117 attributed to coronary heart disease (codes 410–414). Age- and gender-adjusted hazard ratios for all-cause, cardiovascular, and coronary heart disease mortality comparing Mexican Americans with non-Hispanic Whites were 1.50 (95% confidence interval (CI): 1.23, 1.81), 1.70 (95% CI: 1.30, 2.24), and 1.60 (95% CI: 1.09, 2.36), respectively. After adjusting for possible confounders, among diabetic individuals not using insulin, the authors found excess risk of all-cause, cardiovascular, and coronary heart disease mortality associated with being Mexican American; however, in nondiabetic individuals and insulin-using diabetic individuals, Mexican Americans and non-Hispanic Whites appeared to be at similar risk of mortality. Contrary to the prediction of the "Hispanic paradox," in the San Antonio Heart Study, Mexican Americans were at greater risk of all-cause, cardiovascular, and coronary heart disease mortality than were non-Hispanic Whites.
cardiovascular diseases; cohort studies; coronary disease; diabetes mellitus, non-insulin-dependent; Mexican Americans; mortality; risk factors
Abbreviations: Abbreviations: CI, confidence interval; HR, hazard ratio; ICD-9, International Classification of Diseases, Ninth Revision.
CiteULike 
Connotea 
Del.icio.us What's this?
This article has been cited by other articles:
|
|
 |
|
  R. Mehrotra, D. Kermah, L. Fried, S. Adler, and K. Norris Racial Differences in Mortality Among Those with CKD J. Am. Soc. Nephrol., July 1, 2008; 19(7): 1403 - 1410. [Full Text] [PDF]
|
|
|
|
 |
|
 J. L. Akerblom, R. Costa, J. A. Luchsinger, J. J. Manly, M.-X. Tang, J. H Lee, R. Mayeux, and N. Schupf Relation of plasma lipids to all-cause mortality in Caucasian, African-American and Hispanic elders Age Ageing, March 1, 2008; 37(2): 207 - 213. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 E. M. Crimmins, J. K. Kim, D. E. Alley, A. Karlamangla, and T. Seeman Hispanic Paradox in Biological Risk Profiles Am J Public Health, July 1, 2007; 97(7): 1305 - 1310. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
C. A. Peralta, M. G. Shlipak, D. Fan, J. Ordonez, J. P. Lash, G. M. Chertow, and A. S. Go Risks for End-Stage Renal Disease, Cardiovascular Events, and Death in Hispanic versus Non-Hispanic White Adults with Chronic Kidney Disease J. Am. Soc. Nephrol., October 1, 2006; 17(10): 2892 - 2899. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
H. T. Nguyen and A. G. Stack Ethnic Disparities in Cardiovascular Risk Factors and Coronary Disease Prevalence among Individuals with Chronic Kidney Disease: Findings from the Third National Health and Nutrition Examination Survey J. Am. Soc. Nephrol., June 1, 2006; 17(6): 1716 - 1723. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A. J. Thomas, L. E. Eberly, J. D. Neaton, G. D. Smith, and for the Multiple Risk Factor Intervention Trial Re Latino Risk-adjusted Mortality in the Men Screened for the Multiple Risk Factor Intervention Trial Am. J. Epidemiol., September 15, 2005; 162(6): 569 - 578. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 T. D. Hill, J. L. Angel, C. G. Ellison, and R. J. Angel Religious Attendance and Mortality: An 8-Year Follow-Up of Older Mexican Americans J. Gerontol. B. Psychol. Sci. Soc. Sci., March 1, 2005; 60(2): S102 - S109. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 P. Muntner, J. He, J. A. Cutler, R. P. Wildman, and P. K. Whelton Trends in Blood Pressure Among Children and Adolescents JAMA, May 5, 2004; 291(17): 2107 - 2113. [Abstract] [Full Text] [PDF]
|
|