title: Impact of Individual and Neighborhood Factors on Cardiovascular Risk in White Hispanic and Non-Hispanic Women and Men.
abstract: Cardiovascular disease (CVD) is the leading cause of mortality for adults in the US, regardless of ethnicity. A cross-sectional correlational design was used to describe and compare CVD risk and cardiac mortality in White Hispanic and non-Hispanic women and men. Data from 3,317 individuals (1,523 women and 1,794 men) hospitalized for non-cardiac causes during 2012-2013, and data from the 2010 United States Census were included. The sex-specific 10-year Framingham General Cardiovascular Risk Score (FRS-10) was used to estimate long-term risk for major cardiac events. Approximately three-quarters of the sample was White Hispanic. FRS-10 scores were generally low, but a high prevalence of risk factors not included in the standard FRS-10 scoring formula was seen. White Hispanic women had significantly lower estimated CVD risk scores compared to White Hispanic and non-Hispanic men despite higher non-FRS-10 risks. Neighborhood median household income had a significant negative relationship and Hispanic neighborhood concentration had a significant positive relationship with cardiac mortality. Hispanic concentration was the only predictor of estimated CVD risk in a multilevel model. CVD risk assessment tools that are calibrated for ethnic groups and socioeconomic status may be more appropriate for Hispanic individuals than the FRS-10. Neighborhood-level factors should be included in clinical cardiac assessment in addition to individual characteristics and behavioral risks. Researchers should continue to seek additional risk factors that may contribute to or protect against CVD in order to close the gap between estimated CVD risk and actual cardiac mortality for Hispanics in the US. © 2016 Wiley Periodicals, Inc.
authors.affiliation: Nurse Scientist, Baptist Health South Florida, 3161 SW 19th Street, Fort Lauderdale, FL 33312.
authors.forename: Tanya
authors.initials: T
authors.lastname: Cohn
authors.affiliation: Professor, College of Nursing, Rush University, Chicago, IL.
authors.forename: Arlene
authors.initials: A
authors.lastname: Miller
authors.affiliation: Associate Professor and Statistician, College of Nursing, Rush University, Chicago, IL.
authors.forename: Louis
authors.initials: L
authors.lastname: Fogg
authors.affiliation: Professor and Clinical Lipid Specialist, College of Nursing, Rush University, Chicago, IL.
authors.forename: Lynne T
authors.initials: LT
authors.lastname: Braun
authors.affiliation: Assistant Professor, College of Nursing, Rush University, Chicago, IL.
authors.forename: Lola
authors.initials: L
authors.lastname: Coke
mesh_terms: D002318:Cardiovascular Diseases / Q000453:epidemiology* / Q000208:ethnology; D003430:Cross-Sectional Studies; D005006:Ethnicity; D005260:Female; D006630:Hispanic or Latino / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D015995:Prevalence; D012111:Residence Characteristics; D012307:Risk Factors; D012923:Social Class; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
keywords: cardiovascular risk; framingham risk score; hispanic; neighborhood; socioeconomic status