title: Cardiovascular disease mortality in Hispanics and non-Hispanic whites.
abstract: Despite a worse cardiovascular disease (CVD) risk profile, Hispanics have lower CVD mortality than non-Hispanic Whites in studies based on death certificates. This study examined 310 deaths that occurred between 1984 and 1998 among 1,862 Hispanic and non-Hispanic White participants in the San Luis Valley Diabetes Study, using medical records to classify cause of death. Among persons without diabetes, the age-adjusted all-cause mortality rate was 6.1/1,000 person-years in non-Hispanic Whites and 7.4/1,000 person-years in Hispanics. Among persons with diabetes, it was 24.3/1,000 person-years in non-Hispanic Whites and 21.9/1,000 person-years in Hispanics. Among nondiabetics, the age-adjusted CVD mortality rate was 2.5/1,000 person-years in non-Hispanic Whites and 1.6/1,000 person-years in Hispanics. Among diabetics, it was 12.9/1,000 person-years in non-Hispanic Whites and 8.8/1,000 person-years in Hispanics. Among nondiabetics, the adjusted hazard ratio for CVD death in Hispanics compared with non-Hispanic Whites was 0.65 (95% confidence interval (CI): 0.34, 1.23). The hazard ratio for coronary heart disease death was 0.95 (95% CI: 0.35, 2.59). Among diabetics, the hazard ratio for CVD death, after adjustment for conventional and diabetes risk factors, was 0.44 (95% CI: 0.26, 0.74), and for coronary heart disease death it was 0.43 (95% CI: 0.21, 0.91). A statistically significant decreased risk of CVD death was observed only in male Hispanics with diabetes. Competing mortality or factors that interact with diabetes may explain these differences.
authors.affiliation: Department of Preventive Medicine and Biometrics, University of Colorado Health Sciences Center, Denver, CO 80262, USA.
authors.forename: Carolyn J
authors.initials: CJ
authors.lastname: Swenson
authors.forename: Mary Jo
authors.initials: MJ
authors.lastname: Trepka
authors.forename: Marian J
authors.initials: MJ
authors.lastname: Rewers
authors.forename: Sharon
authors.initials: S
authors.lastname: Scarbro
authors.forename: William R
authors.initials: WR
authors.lastname: Hiatt
authors.forename: Richard F
authors.initials: RF
authors.lastname: Hamman
mesh_terms: D017677:Age Distribution; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000209:etiology / Q000401:mortality*; D002423:Cause of Death; D003120:Colorado / Q000453:epidemiology; D003924:Diabetes Mellitus, Type 2 / Q000150:complications* / Q000208:ethnology*; D005260:Female; D005500:Follow-Up Studies; D006630:Hispanic or Latino / Q000235:genetics / Q000706:statistics & numerical data*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D012423:Rural Health / Q000706:statistics & numerical data; D017678:Sex Distribution; D044465:White People / Q000706:statistics & numerical data*