ARS | Publication request: Prevalence of cardiovascular disease risk factors among older Puerto Rican adults living in Massachusetts

Submitted to: Journal of Immigrant and Minority Health
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: January 24, 2011
Publication Date: February 6, 2011
Citation: Van Rompay, M., Castaneda-Sceppa, C., Mckeown, N., Ordovas, J., Tucker, K. 2011. Prevalence of cardiovascular disease risk factors among older Puerto Rican adults living in Massachusetts. Journal of Immigrant and Minority Health. 13(5):825-833.

Interpretive Summary: Hispanic Americans are among the largest and fastest growing ethnic groups in the US. Like other ethnic groups, they experience health disparities for many chronic diseases of aging, and our limited understanding of the underlying factors prevents the elimination of these disparities. We studied several important risk factors for cardiovascular disease (CVD) in the Boston Puerto Rican Health Study. Because we had previously determined that diabetes was very common in this group and diabetes is a well-established risk factor for CVD, we studied CVD from the perspective of three groups: people with normal blood sugar, people with higher than normal blood sugar (but not yet diabetic) and people who had progressed to diabetes. Compared to those with normal blood sugar, those with those with high blood sugar or diabetes had more obesity and more abnormal blood lipids. We also determined that control of health problems related to diabetes, including cholesterol, blood pressure and the level of blood sugar over time, was poor among diabetics in the Boston Puerto Rican Health Study. Socio-economic status, especially poverty, female gender and alcohol use were related to whether or not diabetes-related health problems were under control. In summary, social and behavioral factors as well as obesity are important contributors to the burden of health disparities in this growing ethnic group.

Technical Abstract: There remains limited research on cardiovascular disease (CVD) risk factors in Puerto Rican adults. We compared lifestyle and CVD risk factors in Puerto Rican men and women with normal fasting glucose (NFG), impaired fasting glucose (IFG), or type 2 diabetes (T2D), and investigated achievement of American Diabetes Association (ADA) treatment goals in those with T2D. Baseline data from the Boston Puerto Rican Health Study were analyzed, which included 1,287 adults aged 45–75 years. Obesity, hyperglycemia, and dyslipidemia were prevalent and increased from NFG to IFG and T2D. In individuals without T2D, fasting insulin correlated significantly with body mass index. Achievement of ADA goals was poor; LDL cholesterol was most achieved (59.4%), followed by blood pressure (27.2%) and glycosylated hemoglobin (27.0%). Poverty, female sex, current alcohol use, and diabetes or anti-hypertensive medication use were associated with not meeting goals. Puerto Rican adults living in the Boston area showed several metabolic abnormalities and high CVD risk, likely due to pervasive obesity and socio-economic disparities.