The Role of Ethnicity in Developing Cardiovascular Disease in At-Risk Populations

Abstract

In the U.S., cardiovascular disease (CVD) is responsible for 1 in 4 deaths. There are known predictors (e.g., obesity, hypertension, and dyslipidemia) that increase the odds of developing CVD; however, risk is not proportionate among all ethnicities. While Hispanic Americans often display markers of elevated risk, they have longer life expectancies than their non-Hispanic counterparts. Further exploration of this phenomenon is necessary to elucidate how risk engenders disease in different ethnic groups. PURPOSE: To evaluate CVD risk factors and the incidence of adverse cardiovascular events among at-risk Hispanic and non-Hispanic adults. METHODS: We enrolled 10 Hispanic and 41 non-Hispanic men and women with Type 2 diabetes in a 10-week exercise program. Prior to initiating exercise, we documented demographic data, collected a health history, conducted 7 tests of physical functioning, and measured cardiometabolic variables, including body mass index (BMI), body fat percent (BF%), blood pressure, heart rate, and HBA1C. We repeated all assessments following the intervention. Differences between ethnic groups in baseline values and exercise responses were evaluated with independent- samples t-tests and chi-squared tests. RESULTS: Hispanic subjects had fewer diagnoses of hypertension (p=0.002) and no history of heart attack, compared to 25% incidence among non-Hispanics (p=0.077). Hispanic subjects were 8.1 years younger (p=0.032), 40% of them smoked (compared to 0%; p<0.001), and they had better body compositions as measured by BMI (p=0.038), BF% (p=0.021), and categorical obesity (p=0.030). Physical functioning was slightly better among Hispanic subjects as measured by the minute walk (p=0.010) and functional reach (p=0.029). Participants who completed the exercise program experienced improvement in all assessments but grip strength; there were no differences in improvement between ethnic groups. CONCLUSION: We found exercise to benefit Hispanic and non-Hispanic subjects similarly. Hispanic adults with diabetes had a lower incidence of heart attacks. This may be attributable to observed anthropometric differences; however, if nutritional or behavior customs confercardio- protective effects in this population, it is important for future researchers to identify those variables.