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 Researchers examined heart ultrasounds for more than 1,800 Hispanic/latino
adults in four U.S. cities and found about half of them had cardiac
dysfunction that put them at increased risk for heart failure, a
chronic disease that happens when the heart can’t pump enough blood
to keep the body healthy.
But fewer than 1 in 20 of these patients with cardiac dysfunction
knew they had a problem, the authors report in the journal
Circulation: Heart Failure.
This may be at least in part due to the lack of symptoms, at least
initially, said lead author Dr. Hardik Mehta of Wake Forest Baptist
Medical Center in Winston-Salem, North Carolina.
Hispanics are particularly vulnerable to heart pumping problems
because they are more likely than other people to have risk factors
for heart failure such as diabetes, obesity and high blood pressure,
Mehta and colleagues note.
“The prevalence of risk factors has been known to be higher, but now
we know that the prevalence of asymptomatic cardiac dysfunction is
also very high,” Mehta said by email.
“When compared with other ethnicities with high risk factors, like
non-Hispanic blacks, Hispanics still have a higher prevalence of
cardiac dysfunction,” Mehta added.
To assess the risk of heart pumping problems among Hispanic and
Latino adults, Mehta and colleagues studied people between the ages
of 45 and 74 in New York, Chicago, Miami and San Diego.
Patients were 57 years old on average and 43 percent were men.
Roughly 32 percent were Cuban Americans, 20 percent Mexican
Americans, 18 percent Dominican, 17 percent Puerto Rican, 6 percent
Central American and 6 percent of South American descent.
About half of participants had what’s known as left ventricular
diastolic dysfunction, when the lower left chamber of the heart
doesn't relax enough between beats to gather enough blood.
About 4 percent had what’s known as left ventricular systolic
dysfunction, when the heart’s largest chamber doesn’t push blood out
into the body as forcefully as it should.
Risk factors for these types of cardiac dysfunction – high blood
pressure, diabetes, obesity, limited activity and smoking – also put
these patients at higher odds of developing heart failure, the
authors note.
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The findings suggest that Hispanic/Latino patients would benefit
from screening for diabetes and other risk factors to help catch
problems before heart failure develops, said Dr. Andrew Krumerman, a
researcher at the Montefiore Einstein Center for Heart and Vascular
Care in New York who wasn’t involved in the study.
“Patients should ask their primary care physicians about screening,”
Krumerman said by email. “They should seek out exercise programs and
begin to increase their activity level, while making healthy choices
when it comes to their diet.”
It’s important for doctors to also understand that Hispanic isn’t a
precise racial or ethnic group, it’s a cultural and social way
people may describe themselves when they have origins in many parts
of the world, said Dr. Keith Ferdinand, a researcher at Tulane
University School of Medicine in New Orleans who wasn’t involved in
the study.
“Hispanics can be white, black, Asian, or as in most cases, of mixed
heritage,” Ferdinand added by email. “Each individual needs to be
assessed based on his/her risk and not on somewhat artificial
categories.”
At the same time, all patients, including Hispanics, should be
familiar with the signs and symptoms of heart failure, said Dima
Qato, a pharmacy and health outcomes researcher at the University of
Illinois at Chicago who wasn’t involved in the study. These include
shortness of breath, persistent cough and fatigue, Qato said by
email.
For some Hispanic patients, it’s also possible moving to the U.S.
may have led them to adopt unhealthy American habits like eating
junk food and sitting in front of the television too much, said Dr.
Kevin Thomas, a researcher at Duke University who wasn’t involved in
the study.
“Acculturation to the U.S. has led to decreased activity, obesity
and worse health outcomes,” Thomas said by email.
SOURCE: http://bit.ly/23ck8Su Circulation: Heart Failure, online
April 5, 2016.
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