title: Statin and Aspirin Use Among Hispanic and Latino Adults at High Cardiovascular Risk: Findings From the Hispanic Community Health Study/Study of Latinos.
abstract: BACKGROUND
  Despite variations in the prevalence of cardiovascular disease and related risk factors among US Hispanic/Latino adults of diverse backgrounds, there is little information on whether disparities exist in the use of medications for the primary and secondary prevention of cardiovascular disease. We examined the prevalence of statin and aspirin use among diverse US Hispanic/Latino adults at high cardiovascular risk.
  
  
  RESULTS
  A multicenter population-based study, the Hispanic Community Health Study/Study Of Latinos, included a total of 16 415 participants of Mexican, Puerto Rican, Cuban, Dominican, South American, and Central American backgrounds who were aged 18 to 74 years and enrolled between March 2008 and June 2011. Our analyses were limited to 4139 participants considered to be at high cardiovascular risk. Age-adjusted prevalence of statin and aspirin use was 25% and 44%, respectively, overall but varied by Hispanic/Latino background among those at high cardiovascular risk; statin use was significantly higher (P<0.001) among adults of Puerto Rican (33%) and Dominican (28%) backgrounds compared with adults of other backgrounds (Mexican, 24%; Cuban, 22%; Central American, 20%; South American, 22%). There was no difference in aspirin use. After adjusting for health insurance coverage, the difference in prevalence of statin use was substantially reduced among participants with a Puerto Rican background, from an odds ratio of 1.73 (95% CI 1.30-2.31) to 1.30 (95% CI 0.97-1.75), and with a Dominican background, from an odds ratio of 1.45 (95% CI 1.04-2.02) to 1.07 (95% CI 0.75-1.52), in comparison to their counterparts.
  
  
  CONCLUSIONS
  Among Hispanic/Latino adults of diverse backgrounds, statin use was more prevalent among adults with Puerto Rican and Dominican backgrounds at high cardiovascular risk. These differences in statin use were explained, in part, by differences in insurance coverage. These findings have important implications for the prevention of disparities in cardiovascular outcomes within the growing US Hispanic/Latino population.
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, University of Illinois College of Pharmacy, Chicago, IL Division of Epidemiology and Biostatistics, University of Illinois School of Public Health, Chicago, IL dimaqato@uic.edu.
authors.forename: Dima M
authors.initials: DM
authors.lastname: Qato
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, University of Illinois College of Pharmacy, Chicago, IL Division of Epidemiology and Biostatistics, University of Illinois School of Public Health, Chicago, IL.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Lee
authors.affiliation: Department of Biostatistics, Loyola University Chicago, Chicago, IL Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, IL.
authors.forename: Ramon
authors.initials: R
authors.lastname: Durazo-Arvizu
authors.affiliation: Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, IL.
authors.forename: Donghong
authors.initials: D
authors.lastname: Wu
authors.affiliation: Department of Pharmacy Systems, Outcomes and Policy, University of Illinois College of Pharmacy, Chicago, IL Division of Epidemiology and Biostatistics, University of Illinois School of Public Health, Chicago, IL.
authors.forename: Jocelyn
authors.initials: J
authors.lastname: Wilder
authors.affiliation: Department of Psychology, University of Miami, Coral Gables, FL.
authors.forename: Samantha A
authors.initials: SA
authors.lastname: Reina
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, NC.
authors.forename: Jianwen
authors.initials: J
authors.lastname: Cai
authors.affiliation: Department of Biostatistics, University of North Carolina at Chapel Hill, NC.
authors.forename: Franklyn
authors.initials: F
authors.lastname: Gonzalez
authors.affiliation: Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, CA.
authors.forename: Gregory A
authors.initials: GA
authors.lastname: Talavera
authors.affiliation: Department of Medicine, Division of Cardiology, Montefiore Medical Center, Bronx, NY.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Ostfeld
authors.affiliation: Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, IL.
authors.forename: Martha L
authors.initials: ML
authors.lastname: Daviglus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001241:Aspirin / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000208:ethnology / Q000517:prevention & control*; D002489:Central America / Q000208:ethnology; D003462:Cuba / Q000208:ethnology; D004293:Dominican Republic / Q000208:ethnology; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000627:therapeutic use*; D008297:Male; D017058:Mexican Americans / Q000706:statistics & numerical data; D008875:Middle Aged; D015995:Prevalence; D011647:Puerto Rico / Q000208:ethnology; D012307:Risk Factors; D013020:South America / Q000208:ethnology; D055815:Young Adult
chemical_list: D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D001241:Aspirin
keywords: Hispanic/Latino; cardiovascular risk; disparities; statins