Morbidity: Coronary Heart Disease (CHD)

Since Mexican Americans have adverse patterns of risk factors for atherosclerotic diseases relative to non-Hispanic whites, one would anticipate the prevalence and incidence of CHD should be greater among Mexican Americans. The Corpus Christi Heart Project did report a significantly higher incidence rate of hospitalized myocardial infarction in Mexican-American men and women when compared against their NHW counterparts (Goff, Nichaman, Chan, Ramsey, Labarthe, & Ortiz, 1997).

The San Antonio Study, a population-based survey comparing cardiovascular disease and diabetes incidence among Mexican-Americans and non-Hispanic whites in San Antonio, Texas between 1979 and 1988, contrary to expectations, showed the prevalence of angina pectoris was twice as high in Mexican-Americans compared to NHW (RR=2.01, 95% CI 1.13–3.58 in men; RR=1.84, 95% CI 1.26–2.70 in women) (Mitchell, Hazuda, Haffner, Patterson & Stern, 1991). After controlling for age, body mass index, diabetic status, cigarette smoking, and educational level using logistic regression analysis, the prevalence remained higher (p < .05) in Mexican-American men, but not women.

CHD incidence and prevalence was compared in the Hispanic and NHW populations of San Luis Valley in rural, southern Colorado (Rewers, Shetterly, Hoag, Baxter, Marshall, & Hamman, 1993). This is a unique sub-group of Hispanics, calling themselves Spanish-Americans, that are descendants of 25,000 Spaniards banished from Spain during the Spanish Inquisition (late 1500s and early 1600s) to look for gold in northern New Mexico and southern Colorado.

No evidence was found for a lower incidence, prevalence or mortality due to CHD among Hispanics without diabetes, however, the risk for CHD among diabetic Hispanics was approximately 50% lower than among diabetic NHW, especially men. Whereas the prevalence of CHD in MA with diabetes was not different compared to those without diabetes (RR=1.0, 95% CI 0.6–1.7), NHW with diabetes had significantly higher rates of CHD when compared to NHW without diabetes (RR = 1.9, 95% CI 1.1–3.3). This ethnic pattern persisted after adjustments for various cardiovascular risk factors (age, gender, diabetes, hypertension, smoking, adiposity, and dyslipidemia). A similar pattern of CHD prevalence has been observed in a random sample of community-dwelling Albuquerque, New Mexico residents (Lindeman, Romero, Hundley, Allen, Liang, Baumgartner, Koehler, Schade, & Garry, 1998).