U.S. Hispanics have high risk of heart pumping problems

Hispanic and Latino people in the U.S. have a high risk of heart pumping problems that can lead to heart failure, but most who have these disorders don’t know it, a recent study suggests.

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.

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.