Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018

Safi U. Khan; Ahmad N. Lone; Siva H. Yedlapati; Sourbha S. Dani; Muhammad Zia Khan; Karol E. Watson; Purvi Parwani; Fatima Rodriguez; Miguel Cainzos-Achirica; Erin D. Michos

doi:10.1161/JAHA.121.022857

Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018

Safi U. Khan, Ahmad N. Lone, Siva H. Yedlapati, Sourbha S. Dani, Muhammad Zia Khan, Karol E. Watson, Purvi Parwani, Fatima Rodriguez, Miguel Cainzos-Achirica, Erin D. Michos

Research output: Contribution to journal › Article › peer-review

16 Scopus citations

Abstract

BACKGROUND: Life expectancy has been higher for Hispanic versus non-Hispanic White (NHW) individuals; however, data are limited on cardiovascular disease (CVD) mortality. METHOD AND RESULTS: Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research death certificate database (1999–2018), we compared age-adjusted mortality rates for total CVD and its subtypes (ischemic heart disease, stroke, heart failure, hypertensive heart disease, other CVD), and average annual percentage changes among Hispanic and NHW adults. The age-adjusted mortality rate per 100 000 was lower for Hispanic than NHW adults for total CVD (186.4 versus 254.6; P<0.001) and its subtypes. Between 1999 and 2018, mortality decline was higher in Hispanic than NHW adults for total CVD (average annual percentage change [AAPC], −2.90 versus −2.41) and ischemic heart disease (AAPC: −4.44 versus −3.82) (P<0.001). In contrast, stroke mortality decline was slower in Hispanic versus NHW adults (AAPC: −2.05 versus −2.60; P<0.05). Stroke mortality increased in Hispanic but stalled in NHW adults since 2011 (AAPC: 0.79 versus −0.09). For ischemic heart disease (AAPC: −0.80 versus −1.85) and stroke (AAPC: −1.32 versus −1.43) mortality decline decelerated more for Hispanic than NHW adults aged <45 years (P<0.05). For heart failure, Hispanic adults aged <45 (3.55 versus 2.16) and 45 to 64 (1.88 versus 1.54) showed greater rise in age-adjusted mortality rate than NHW individuals (P<0.05). Age-adjusted heart failure mortality rate also accelerated in Hispanic versus NHW men (1.00 versus 0.67; P<0.001). CONCLUSIONS: Disaggregating data by CVD subtype and demographics unmasked heterogeneities in CVD mortality between Hispanic and NHW adults. NHW adults had greater CVD mortality rates and slower decline than Hispanic adults, whereas marked demographic differences in mortality signaled concerning trends among the Hispanic versus NHW population.

Original language	English (US)
Article number	e022857
Pages (from-to)	e022857
Journal	Journal of the American Heart Association
Volume	11
Issue number	7
DOIs	https://doi.org/10.1161/JAHA.121.022857
State	Published - Apr 5 2022

Keywords

Hispanics
cardiovascular mortality
epidemiology
Cardiovascular Diseases
Stroke
Humans
Middle Aged
Male
Hispanic or Latino
Ethnicity
United States/epidemiology
Heart Failure
Adult
Aged

ASJC Scopus subject areas

Cardiology and Cardiovascular Medicine

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10.1161/JAHA.121.022857

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Khan, S. U., Lone, A. N., Yedlapati, S. H., Dani, S. S., Khan, M. Z., Watson, K. E., Parwani, P., Rodriguez, F., Cainzos-Achirica, M., & Michos, E. D. (2022). Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018. Journal of the American Heart Association, 11(7), e022857. Article e022857. https://doi.org/10.1161/JAHA.121.022857

Khan, SU, Lone, AN, Yedlapati, SH, Dani, SS, Khan, MZ, Watson, KE, Parwani, P, Rodriguez, F, Cainzos-Achirica, M & Michos, ED 2022, 'Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018', Journal of the American Heart Association, vol. 11, no. 7, e022857, pp. e022857. https://doi.org/10.1161/JAHA.121.022857

@article{8af83a42c90d411589f1b8d323ce4153,

title = "Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018",

abstract = "BACKGROUND: Life expectancy has been higher for Hispanic versus non-Hispanic White (NHW) individuals; however, data are limited on cardiovascular disease (CVD) mortality. METHOD AND RESULTS: Using the Centers for Disease Control and Prevention{\textquoteright}s Wide-Ranging Online Data for Epidemiologic Research death certificate database (1999–2018), we compared age-adjusted mortality rates for total CVD and its subtypes (ischemic heart disease, stroke, heart failure, hypertensive heart disease, other CVD), and average annual percentage changes among Hispanic and NHW adults. The age-adjusted mortality rate per 100 000 was lower for Hispanic than NHW adults for total CVD (186.4 versus 254.6; P<0.001) and its subtypes. Between 1999 and 2018, mortality decline was higher in Hispanic than NHW adults for total CVD (average annual percentage change [AAPC], −2.90 versus −2.41) and ischemic heart disease (AAPC: −4.44 versus −3.82) (P<0.001). In contrast, stroke mortality decline was slower in Hispanic versus NHW adults (AAPC: −2.05 versus −2.60; P<0.05). Stroke mortality increased in Hispanic but stalled in NHW adults since 2011 (AAPC: 0.79 versus −0.09). For ischemic heart disease (AAPC: −0.80 versus −1.85) and stroke (AAPC: −1.32 versus −1.43) mortality decline decelerated more for Hispanic than NHW adults aged <45 years (P<0.05). For heart failure, Hispanic adults aged <45 (3.55 versus 2.16) and 45 to 64 (1.88 versus 1.54) showed greater rise in age-adjusted mortality rate than NHW individuals (P<0.05). Age-adjusted heart failure mortality rate also accelerated in Hispanic versus NHW men (1.00 versus 0.67; P<0.001). CONCLUSIONS: Disaggregating data by CVD subtype and demographics unmasked heterogeneities in CVD mortality between Hispanic and NHW adults. NHW adults had greater CVD mortality rates and slower decline than Hispanic adults, whereas marked demographic differences in mortality signaled concerning trends among the Hispanic versus NHW population.",

keywords = "Hispanics, cardiovascular mortality, epidemiology, Cardiovascular Diseases, Stroke, Humans, Middle Aged, Male, Hispanic or Latino, Ethnicity, United States/epidemiology, Heart Failure, Adult, Aged",

author = "Khan, {Safi U.} and Lone, {Ahmad N.} and Yedlapati, {Siva H.} and Dani, {Sourbha S.} and Khan, {Muhammad Zia} and Watson, {Karol E.} and Purvi Parwani and Fatima Rodriguez and Miguel Cainzos-Achirica and Michos, {Erin D.}",

note = "Funding Information: Dr Michos is supported by the Amato Fund for Women{\textquoteright}s Cardiovascular Health research at Johns Hopkins University. Dr Michos is additionally supported by the American Heart Association Strategic Focused Research Network grant 20SFRN35380046. Dr Rodriguez is supported by the National Heart, Lung, and Blood Institite K01 HL 144607 (FRR) and the American Heart Association/Robert Wood Johnson Harold Amos Medical Faculty Development Program. Publisher Copyright: {\textcopyright} 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.",

year = "2022",

month = apr,

day = "5",

doi = "10.1161/JAHA.121.022857",

language = "English (US)",

volume = "11",

pages = "e022857",

journal = "Journal of the American Heart Association",

issn = "2047-9980",

publisher = "Wiley",

number = "7",

}

TY - JOUR

T1 - Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018

AU - Khan, Safi U.

AU - Lone, Ahmad N.

AU - Yedlapati, Siva H.

AU - Dani, Sourbha S.

AU - Khan, Muhammad Zia

AU - Watson, Karol E.

AU - Parwani, Purvi

AU - Rodriguez, Fatima

AU - Cainzos-Achirica, Miguel

AU - Michos, Erin D.

N1 - Funding Information: Dr Michos is supported by the Amato Fund for Women’s Cardiovascular Health research at Johns Hopkins University. Dr Michos is additionally supported by the American Heart Association Strategic Focused Research Network grant 20SFRN35380046. Dr Rodriguez is supported by the National Heart, Lung, and Blood Institite K01 HL 144607 (FRR) and the American Heart Association/Robert Wood Johnson Harold Amos Medical Faculty Development Program. Publisher Copyright: © 2022 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

PY - 2022/4/5

Y1 - 2022/4/5

N2 - BACKGROUND: Life expectancy has been higher for Hispanic versus non-Hispanic White (NHW) individuals; however, data are limited on cardiovascular disease (CVD) mortality. METHOD AND RESULTS: Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research death certificate database (1999–2018), we compared age-adjusted mortality rates for total CVD and its subtypes (ischemic heart disease, stroke, heart failure, hypertensive heart disease, other CVD), and average annual percentage changes among Hispanic and NHW adults. The age-adjusted mortality rate per 100 000 was lower for Hispanic than NHW adults for total CVD (186.4 versus 254.6; P<0.001) and its subtypes. Between 1999 and 2018, mortality decline was higher in Hispanic than NHW adults for total CVD (average annual percentage change [AAPC], −2.90 versus −2.41) and ischemic heart disease (AAPC: −4.44 versus −3.82) (P<0.001). In contrast, stroke mortality decline was slower in Hispanic versus NHW adults (AAPC: −2.05 versus −2.60; P<0.05). Stroke mortality increased in Hispanic but stalled in NHW adults since 2011 (AAPC: 0.79 versus −0.09). For ischemic heart disease (AAPC: −0.80 versus −1.85) and stroke (AAPC: −1.32 versus −1.43) mortality decline decelerated more for Hispanic than NHW adults aged <45 years (P<0.05). For heart failure, Hispanic adults aged <45 (3.55 versus 2.16) and 45 to 64 (1.88 versus 1.54) showed greater rise in age-adjusted mortality rate than NHW individuals (P<0.05). Age-adjusted heart failure mortality rate also accelerated in Hispanic versus NHW men (1.00 versus 0.67; P<0.001). CONCLUSIONS: Disaggregating data by CVD subtype and demographics unmasked heterogeneities in CVD mortality between Hispanic and NHW adults. NHW adults had greater CVD mortality rates and slower decline than Hispanic adults, whereas marked demographic differences in mortality signaled concerning trends among the Hispanic versus NHW population.

AB - BACKGROUND: Life expectancy has been higher for Hispanic versus non-Hispanic White (NHW) individuals; however, data are limited on cardiovascular disease (CVD) mortality. METHOD AND RESULTS: Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research death certificate database (1999–2018), we compared age-adjusted mortality rates for total CVD and its subtypes (ischemic heart disease, stroke, heart failure, hypertensive heart disease, other CVD), and average annual percentage changes among Hispanic and NHW adults. The age-adjusted mortality rate per 100 000 was lower for Hispanic than NHW adults for total CVD (186.4 versus 254.6; P<0.001) and its subtypes. Between 1999 and 2018, mortality decline was higher in Hispanic than NHW adults for total CVD (average annual percentage change [AAPC], −2.90 versus −2.41) and ischemic heart disease (AAPC: −4.44 versus −3.82) (P<0.001). In contrast, stroke mortality decline was slower in Hispanic versus NHW adults (AAPC: −2.05 versus −2.60; P<0.05). Stroke mortality increased in Hispanic but stalled in NHW adults since 2011 (AAPC: 0.79 versus −0.09). For ischemic heart disease (AAPC: −0.80 versus −1.85) and stroke (AAPC: −1.32 versus −1.43) mortality decline decelerated more for Hispanic than NHW adults aged <45 years (P<0.05). For heart failure, Hispanic adults aged <45 (3.55 versus 2.16) and 45 to 64 (1.88 versus 1.54) showed greater rise in age-adjusted mortality rate than NHW individuals (P<0.05). Age-adjusted heart failure mortality rate also accelerated in Hispanic versus NHW men (1.00 versus 0.67; P<0.001). CONCLUSIONS: Disaggregating data by CVD subtype and demographics unmasked heterogeneities in CVD mortality between Hispanic and NHW adults. NHW adults had greater CVD mortality rates and slower decline than Hispanic adults, whereas marked demographic differences in mortality signaled concerning trends among the Hispanic versus NHW population.

KW - Hispanics

KW - cardiovascular mortality

KW - epidemiology

KW - Cardiovascular Diseases

KW - Stroke

KW - Humans

KW - Middle Aged

KW - Male

KW - Hispanic or Latino

KW - Ethnicity

KW - United States/epidemiology

KW - Heart Failure

KW - Adult

KW - Aged

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U2 - 10.1161/JAHA.121.022857

DO - 10.1161/JAHA.121.022857

M3 - Article

C2 - 35362334

AN - SCOPUS:85128245435

SN - 2047-9980

VL - 11

SP - e022857

JO - Journal of the American Heart Association

JF - Journal of the American Heart Association

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ER -

Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018

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