Self-reported heart attack in Mexican-American elders: examination of incidence, prevalence, and 7-year mortality.
OBJECTIVE
To examine the prevalence, incidence, and mortality of self-reported heart attack in older Mexican Americans and to identify significant factors associated with heart attack.


METHODS
Cross-sectional and longitudinal study.


METHODS
Baseline and three follow-up interviews in five southwestern states (Arizona, California, Colorado, New Mexico, and Texas) of the Hispanic Established Population for the Epidemiological Study of the Elderly.


METHODS
Three thousand fifty Mexican Americans aged 65 to 107 (mean age = 73).


METHODS
Sociodemographic factors (age, sex, marital status, language of interview, health insurance coverage, living arrangements, and financial strain) and health factors (smoking, alcohol consumption, obesity, diabetes mellitus, hypertension, stroke, cancer, hip fracture, arthritis, depression, limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and mortality) were determined at baseline (1993-94). New heart attacks were assessed at follow-ups in 1995-96, 1998-99, and 2000-01. Vital status was determined over the 7-year follow-up.


RESULTS
Prevalence of self-reported heart attack was 9.1% at baseline. Incidence of self-reported heart attack was 6.1%, 9.1%, and 7.9%, respectively, for the three subsequent follow-ups. Older age, male sex, diabetes mellitus, hypertension, and stroke were significantly associated with heart attack at baseline. Age was a significant predictor for new heart attack at each follow-up. Having ADL (odds ratio (OR) = 2.91, 95% confidence interval (CI) = 2.19-3.86) and IADL (OR = 2.25, CI = 1.72-2.94) disabilities was significantly associated with self-reported heart attack. Subjects with heart attack were significantly more likely to die at 7 years (hazard ratio = 1.57, 95% CI = 1.29-1.91). Of those with self-reported heart attack, 42.4% had died of heart attack as the underlying cause of death by 7-year follow-up.


CONCLUSIONS
In Mexican Americans, self-reported heart attack was associated with being older and male and having diabetes mellitus, hypertension, stroke, and ADL and IADL disabilities. Nearly half of subjects with heart attack had died of heart attack as underlying cause of death by 7-year follow-up. Prevention and control for this disease would be especially important in this population to avoid early mortality.
Otiniano
Max E
ME
Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas 77555, USA.
Ottenbacher
Kenneth J
KJ
Markides
Kyriakos S
KS
Ray
Laura A
LA
Du
Xianglin L
XL
D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data*; D009203:Myocardial Infarction / Q000175:diagnosis / Q000453:epidemiology* / Q000208:ethnology*; D015995:Prevalence; D012307:Risk Factors; D012650:Self Disclosure; D012959:Socioeconomic Factors; D015996:Survival Rate; D013997:Time Factors; D014481:United States / Q000453:epidemiology