A snapshot of cardiovascular health in the Hispanic population

The Hispanic population is extraordinarily diverse, with individuals whose heritage spans many countries across Latin America and the Caribbean. It is the largest, and fastest growing, ethnic group in the country – and as with all Americans, cardiovascular health is a top concern.

What do we know about cardiovascular risk among Hispanic populations in the U.S.?

Heart disease is the number one killer of all Americans, both Hispanics and non-Hispanics alike. A high percentage of Hispanic/Latino individuals (80% of men and 71% of women) have at least one cardiovascular disease risk factor.

“Hispanic people have the same risk factors that non-Hispanics do. They’re at risk of having heart disease, high cholesterol, high blood pressure and heart failure, just like the U.S. population as a whole is,” said advanced heart failure and transplant cardiologist Vanessa Blumer, MD, FACC, FHFSA, Associate Program Director of the Cardiovascular Fellowship Program and Associate Director of Heart Failure Research at Inova Schar Heart and Vascular. “One unique thing about Hispanics is that, as a group, they tend to develop heart disease at younger ages and they tend to be sicker, with additional chronic conditions, when they enter the healthcare system.”

Despite being more likely to have severe cardiovascular disease, as well as additional health issues that affect the heart (like chronic kidney disease, diabetes or high blood pressure), researchers have found a surprising trend, which they term “the Hispanic paradox.”

“The Hispanic paradox is that patients of Hispanic origin, even though they are generally sicker and have more comorbidities when they seek care, have a mortality rate comparable – and in some cases, even better – than that of non-Hispanics,” Dr. Blumer said.

Social drivers of health

While this is by no means true of every individual, taken as a whole, Hispanic populations face disproportionately higher barriers to seeking care, creating care gaps. Social drivers of health are factors outside the healthcare system that nonetheless affect a person’s health outcomes. Examples include food insecurity, transportation difficulties, education level, income level, housing issues and language barriers, which can pose challenges for people who are not fluent in reading, writing and speaking English.  

“It’s important to be sensitive to language considerations when we are caring for patients, as well as trying to understand the broader cultural context as it relates to health literacy, education and social determinants of health,” said Marina Ocasio, MSN, RN, CNL, Senior Director of Nursing at Inova Schar Heart and Vascular.

Another layer that complicates the cardiovascular risk picture for Hispanic populations is a concept called acculturation, which means how much a given individual or family has absorbed mainstream American cultural practices as opposed to cultural practices arising from their heritage.

“The degree of acculturation among Hispanics in the U.S. contributes to differences in health outcomes,” Dr. Blumer said. “It’s one more way in which the Hispanic population is heterogeneous and complex, and very much not a one-size-fits-all community.”

Cultural humility is key to care excellence

Healthcare providers must focus on practicing cultural humility for all communities they serve. From offering interpretive services, including in-person interpretation whenever possible, to understanding how broader familial and societal structures may affect a patient’s ability to follow a given treatment plan.

“One of the things that drew me to nursing to begin with was the great need I saw in patients who spoke English as a second language and their struggles in trying to communicate and understand how treatment considerations would realistically and practically be applied in their lives,” Ocasio said. “If you’re not a native English speaker and don’t have an advocate, it can be hugely challenging.”

“Language barriers are challenges, but they are also opportunities for deeper connection,” said Jason Bonomo, MD, PhD, FACC, Kruvant Director, Cardiovascular Community Health at Inova Schar Heart and Vascular.

Inova ensures every patient has access to in-person or video interpreter services. In addition, Inova encourages physicians to develop a high “emotional quotient” (EQ) to notice nonverbal cues and body language as well as spoken language.

Inova is actively working to bridge gaps in care

A recent needs assessment conducted by Inova and local county governments identified several communities in Northern Virginia with high rates of 30-day heart failure readmissions and critical limb ischemia, yet the lowest utilization of advanced cardiac therapies.

“To address this, we are bringing cardiovascular care into those communities,” Dr. Bonomo said.

This will help minimize travel barriers and meet patients where they are particularly for patients with high cardiometabolic risk and for those who are uninsured or underinsured.

Tips to support everyone’s heart health

• See your primary care provider regularly, so you can catch problems early, before they turn into cardiovascular disease
• Know your heart risks – including your family history of cardiovascular disease
• Eat a heart-healthy diet – for specific guidelines, check out the Mediterranean diet or the DASH diet
• Exercise for 30 minutes, five times a week – a simple daily walk can do wonders
• Avoid smoking and tobacco products – and if you already smoke or use tobacco, quit
• Drink alcohol moderately, if at all
• If you think something’s not right with your heart, don’t wait – call your primary care provider and get it checked out
• Progress is better than perfection – start with one small healthy change, and build from there

A great next step

Whether you need a primary care provider or a heart specialist, Inova offers great options, and you can search by language at Inova.org/Doctors.