Abstract Body: Objective: The long-term trends of cardiovascular health (CVH) in the US Hispanic/Latino population are incompletely understood. We aimed to assess CVH longitudinally using metrics based on the American Heart Association's Life's Essential 8 (LE8). To investigate the "Hispanic resilience" phenomenon, we compared Hispanic and non-Hispanic data from US-wide samples.
Methods: We included HCHS/SOL enrollees aged 28 to 74 free of cardiovascular diseases at baseline (2008-2011, n=12,724) and at Visit 2 (2014-2017, n=9,246). We evaluated the weighted prevalence of meeting the ideal levels for five LE8 metrics repeatedly measured at both visits: nicotine exposure, body mass index (BMI), blood lipids, blood glucose, and blood pressure. We also assessed the prevalence of meeting multiple CVH metrics (defined as meeting four or five of the total five measured metrics) by demographic subgroups. Comparisons were made with data from corresponding timeframes from NHANES-Hispanics and NHANES-non-Hispanic Whites (NHW).
Results: Over time, among Hispanics, the prevalence of meeting the blood lipid CVH metric increased (30.0% at baseline, 40.4% at Visit 2), while the prevalence of meeting the blood glucose metric decreased (47.6% to 39.1%). Nicotine exposure, BMI, and blood pressure metrics were unchanged. Among Hispanic/Latino backgrounds, South Americans consistently were most likely to meet multiple CVH metrics over time (18.4% to 18.5%), while Puerto Ricans showed the most improvement across time periods (9.9% to 14.0%). Both Hispanic males and females improved over time, with females having higher achievement of CVH metrics. US-born (i.e., 50 states/DC) Hispanics were more likely to meet most CVH metrics compared to those born outside the US. In comparison with NHANES, the prevalence of meeting the nicotine exposure metric was consistently higher in both HCHS/SOL and NHANES-Hispanics than in NHW. NHANES-NHW participants had a higher prevalence of meeting the BMI and blood lipid metrics compared to Hispanics in HCHS/SOL and NHANES. Across all Hispanic and NHW groups, there was a consistent trend of improvement in the blood lipid metric and a decline in the blood glucose metric.
Conclusion: Across different metrics of CVH, Hispanics/Latinos have both advantages and disadvantages relative to NHW in the US. Across the US, among both Hispanics and NHW, blood lipids have improved over time, while the blood glucose component of CVH has worsened.