Rodriguez F, et al. - Among highly educated Hispanic vs non-Hispanic white (NHW) individuals in a preventive medicine clinic, researchers determined cardiovascular risk and outcomes. Findings revealed that Hispanic and NHW men and women with high educational attainment had a similar risk of atherosclerotic cardiovascular disease, subclinical coronary atherosclerosis, and mortality during follow-up. The Hispanic paradox in a highly educated Hispanic population was not supported in this analysis.

Methods

• Retrospective cohort analysis of participants from the Cooper Center Longitudinal Study who received preventive medical examinations from October 1972 to November 2017 at the Cooper Clinic in Dallas, Texas.
• Analyzes started in April 2018.
• Exposures included ethnicity, self-defined as Hispanic or NHW.
• The prevalence of major metabolic risk factors and cardiorespiratory fitness of participants with at least 2 visits were compared.
• Using regression models, ethnic differences adjusted for age, examination year, and educational attainment were estimated.
• After that, age-matched comparisons of coronary artery calcium scores were performed.
• Using the Kaplan-Meier method, all-cause mortality was summarized.

Results

• The study sample consisted of 1351 Hispanic and 43,736 NHW participants (aged 20 to 80 years, body mass index between 18.5 and 50.0) and were not missing key cardiometabolic or fitness variables.
• Findings revealed that Hispanic and NHW participants had high educational attainment, with a mean of more than 15 years of total education.
• They found that Hispanic women and men had a higher prevalence of metabolic syndrome (71 of 518 [13.1%] vs 1477 of 13 732 [10.8%] for women and 255 of 833 [30.6%] vs 7902 of 30 004 [26.3%] for men, respectively).
• No difference was found in calculated 10-year atherosclerotic cardiovascular disease risk scores by ethnicity although Hispanic individuals were twice as likely to have diabetes.
• During follow-up, both Hispanic and NWH individuals experienced a statistically significant worsening in cardiometabolic parameters although this was not statistically significantly different between groups.
• No significant differences were found in the prevalence of coronary artery calcium scores between Hispanic and NWH individuals in age-matched analyses.
• There was no difference in mortality between Hispanic and NHW individuals during a mean (SD) follow-up of 12.9 (7.5) years.