Effects of cigarette smoking, diabetes, high cholesterol, and hypertension on all-cause mortality and cardiovascular disease mortality in Mexican Americans. The San Antonio Heart Study.
Despite high levels of cardiovascular risk factors, Mexican Americans paradoxically have a lower prevalence of cardiovascular disease. A possible explanation is that conventional cardiovascular risk factors have a lesser impact on this ethnic group. In the present study, a 7- to 8-year follow-up of the San Antonio Heart Study cohort was used to estimate total and cardiovascular disease mortality and their association with baseline risk factors. A total of 2,629 Mexican Americans form the basis of this study, and 1,136 non-Hispanic whites from the same cohort served as the comparison group. The age- and sex-adjusted rates for total death and cardiovascular disease death were somewhat higher in Mexican Americans than non-Hispanic whites (rate ratio for total mortality = 1.4, 95% confidence interval 1.0-2.0; and rate ratio for cardiovascular mortality = 1.3, 95% confidence interval 0.7-2.4). After adjustment for sex, age, and socioeconomic status in multivariate analyses, current smoking, diabetes, high cholesterol, and hypertension were positively associated with all-cause mortality and cardiovascular disease mortality in Mexican Americans. Overall, these risk factors accounted for 45% of all-cause mortality and 55% of cardiovascular disease mortality in this ethnic group. In comparison, the risk factors accounted for 46% of all-cause mortality and 46% of cardiovascular disease mortality in non-Hispanic whites. The authors conclude that cigarette smoking, diabetes, high cholesterol, and hypertension are important predictors of both all-cause and cardiovascular disease deaths in Mexican Americans. There was no evidence for a diminished effect of these risk factors in Mexican Americans.
Wei
M
M
Department of Medicine, University of Texas Health Science Center at San Antonio 78284, USA.
Mitchell
B D
BD
Haffner
S M
SM
Stern
M P
MP
D000328:Adult; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D015331:Cohort Studies; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006801:Humans; D006937:Hypercholesterolemia / Q000150:complications* / Q000208:ethnology; D006973:Hypertension / Q000150:complications* / Q000208:ethnology; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D008875:Middle Aged; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects* / Q000208:ethnology; D044465:White People / Q000706:statistics & numerical data