Adults of different Hispanic/Latino backgrounds in the U.S. who are at high risk of cardiovascular disease vary significantly in their use of widely-prescribed cholesterol-lowering statins even though the drugs could reduce their chance of heart attack or stroke, according to research at the University of Illinois at Chicago.
The disparities, said lead author Dima Mazen Qato, assistant professor of pharmacy systems, outcomes and policy, are due to differences in health insurance.
“Efforts to increase the use of statins, particularly targeting individuals that have already suffered a heart attack or stroke, should include expanding health insurance for all Hispanic/Latino adults that currently lack coverage, regardless of their heritage,” Qato said.
Heart disease is the number-one killer for all Americans, with stroke being the fifth leading cause of death. Cardiovascular disease is increasingly common in the growing and aging U.S. Hispanic/Latino population because of high blood pressure, obesity and diabetes. Statins and aspirin are two of the most prevalent treatment and preventive options.
Investigators discovered statin use was highest among high-risk adults of Puerto Rican descent (33 percent), followed by those of Dominican heritage at 28 percent. The lowest usage was found among those with a Central American background, at 22 percent.
The study is one of the first of its kind to compare the difference in statin and aspirin usage among diverse Hispanic/Latino populations in the U.S.
Results were from 4,139 patients living in the Bronx, New York; Chicago; Miami; and San Diego between 2008 and 2011. Their average age was 52, and about half were women. All were at high risk for heart disease, having already had a heart attack, stroke or diabetes.
Participants underwent a medical examination prior to enrollment and were required to complete a questionnaire about medication use and heart disease history.
According to Qato, one-fourth of Hispanic/Latino adults at high risk took statins and fewer than half (44 percent) took aspirin. Seventeen percent took both. The use of aspirin, which is available without a prescription, was comparable among all Hispanic/Latino groups.
“Efforts to improve statin prescribing in patients likely to benefit are particularly important in patients with a history of heart disease,” Qato said. “Healthcare providers and policy makers should be aware of the role of insurance in the underuse of preventative cardiovascular medications in specific Hispanic/Latino populations.”
Co-authors of the study, published in the Journal of the American Heart Association, are Todd Lee, Jocelyn Wilder, Donghong Wu and Dr. Martha Daviglus of UIC; Ramon Durazo-Arvizu of Loyola University Chicago; Samantha Reina of the University of Miami; Jianwen Cai and Franklyn Gonzalez of the University of North Carolina; Dr. Gregory Talavera of San Diego State University; and Dr. Robert Ostfeld of Montefiore Medical Center in the Bronx.
The Hispanic Community Health Study/Study of Latinos was a collaborative study supported by contracts from the National Heart, Lung and Blood Institute to the University of North Carolina (N01-HC65233), the University of Miami (N01-HC65234), the Albert Einstein College of Medicine (N01-HC65235), Northwestern University (N01-HC65236), UIC (HHSN268201300003I) and San Diego State University (N01-HC65237).
The following Institutes/Centers/Offices contribute to the Hispanic Community Health Study/Study of Latinos through a transfer of funds to the National Heart, Lung and Blood Institute: the National Institute on Minority Health and Health Disparities; the National Institute on Deafness and Other Communication Disorders; the National Institute of Dental and Craniofacial Research; the National Institute of Diabetes and Digestive and Kidney Disease; the National Institute of Neurological Disorders and Stroke; and the NIH Institution-Office of Dietary Supplements.
By: Same Hostettler