Sleep-disordered Breathing in Hispanic/Latino Individuals of Diverse Backgrounds. The Hispanic Community Health Study/Study of Latinos

Rationale: Hispanic/Latino populations have a high prevalence of cardiovascular risk factors and may be at risk for sleep-disordered breathing (SDB). An understanding of SDB among these populations is needed given evidence that SDB increases cardiovascular risk

Smoking among U.S. hispanic/latino adults: The hispanic community health study/study of latinos

Prior national surveys capture smoking behaviors of the aggregate US Hispanic/Latino population, possibly obscuring subgroup variation

Sample Design and Cohort Selection in the Hispanic Community Health Study/Study of Latinos

The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a multi-center, community based cohort study of Hispanic/Latino adults in the United States. A diverse participant sample is required that is both representative of the target population and likely to remain engaged throughout follow-up. The choice of sample design, its rationale, and benefits and challenges of design decisions are described in this paper

Prevalence of Diabetes Among Hispanics/Latinos From Diverse Backgrounds: The Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

OBJECTIVEWe examine differences in prevalence of diabetes and rates of awareness and control among adults from diverse Hispanic/Latino backgrounds in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL).RESEARCH DESIGN AND METHODSThe HCHS/SOL, a prospective, multicenter, population-based study, enrolled from four U.S. metropolitan areas from 2008 to 2011 16,415 18–74-year-old people of Hispanic/Latino descent. Diabetes was defined by either fasting plasma glucose, impaired glucose tolerance 2 h after a glucose load, glycosylated hemoglobin (A1C), or documented use of hypoglycemic agents (scanned medications).RESULTSDiabetes prevalence varied from 10.2% in South Americans and 13.4% in Cubans to 17.7% in Central Americans, 18.0% in Dominicans and Puerto Ricans, and 18.3% in Mexicans (P < 0.0001). Prevalence related positively to age (P < 0.0001), BMI (P < 0.0001), and years living in the U.S. (P = 0.0010) but was negatively related to education (P = 0.0005) and household income (P = 0.0043). Rate of diabetes awareness was 58.7%, adequate glycemic control (A1C <7%, 53 mmol/mol) was 48.0%, and having health insurance among those with diabetes was 52.4%.CONCLUSIONSPresent findings indicate a high prevalence of diabetes but considerable diversity as a function of Hispanic background. The low rates of diabetes awareness, diabetes control, and health insurance in conjunction with the negative associations between diabetes prevalence and both household income and education among Hispanics/Latinos in the U.S. have important implications for public health policies

Periodontitis and Sleep Disordered Breathing in the Hispanic Community Health Study/Study of Latinos

To investigate the association between sleep disordered breathing (SDB) and severe chronic periodontitis

IS CORONARY ANGIOGRAPHY UNDERUSED IN AN INNER-CITY POPULATION?

Purpose: We sought to determine, prospectively, if any race or sex disparities in coronary angiography use was explained by standardized criteria for the procedure. Methods: We prospectively identified 153 patients $40 years of age who underwent evaluation for coronary disease from December 1998 to November 1999 at a municipal hospital. Patients requiring angiography were referred to a nearby academic facility. Information abstracted from medical records was used to assess appropriateness of management and clinical outcomes. Physician reviewers used RAND criteria to rate the appropriateness and necessity for angiography. Multivariate logistic regression models determined predictors of angiography. Results: Blacks and Hispanics made up 78$50% stenosis of a major vessel). In multivariate logistic regression models, urgent indications, such as post-myocardial infarction angina or exacerbation of angina, were the strongest predictors for angiography (odds ratio 3.9, 95% confidence interval 1.7–9.1]). During the 18 months of follow-up, no deaths were seen among the medically treated patients for whom angiography was rated necessary (n526). Conclusion: Angiography was underused in this publicly insured population. Improved access to coronary angiography among minority populations with multiple coronary risk factors is still needed

The Impact of Sociodemographic Factors on Knowledge of Cardiac Procedures

Background: This paper investigates the extent to which sociodemographic factors are associated with knowledge of cardiac procedures in a sample of study participants treated for coronary heart disease (CHD). Research indicates the importance of knowledge of CHD and its associated risks in order to prevent CHD. However, quantification of knowledge levels among individuals undergoing cardiac procedures to treat CHD has not been well documented. Method: Using a cross-sectional design, 156 participants, diverse in race/ethnicity, age, and sex, underwent elective cardiac catheterization for the evaluation of chest pain and/or angina. Participants completed surveys regarding medical history, sociodemographic information, and knowledge of cardiac procedures. Ninety-five of these individuals, with clinically significant CHD, were recommended by their physician to undergo a coronary revascularization procedure [percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass graft (CABG)]. These individuals completed additional knowledge assessment surveys. Results: The overall knowledge scores for those undergoing coronary angiography were suboptimal (M score = 4.6 out of 8). Older aged (&gt; 65), male, married, white, college-educated participants demonstrated greater knowledge of cardiac catheterization procedures (all p values &lt; 0.05). Knowledge scores were greater among those revascularized than among participants undergoing coronary angiography. Conclusions: Health professionals should provide general information about CHD treatment and interventions, especially among women and ethnic minorities

Cigarette Smoking and Depressive Symptoms Among Hispanic/Latino Adults: Results From the Hispanic Community Health Study/Study of Latinos (HCHS/SOL)

In the present study, we investigated associations among cigarette smoking, smoking cessation treatment, and depressive symptoms in Hispanic/Latino adults. The multisite prospective population-based Hispanic Community Health Study/Study of Latinos (HCHS/SOL) enrolled a cohort of Hispanic/Latino adults (aged 18-74) from diverse backgrounds (n = 16,412) in 4U.S. communities (Chicago, San Diego, Miami, and Bronx). Households were selected using a stratified 2-stage probability sampling design and door-to-door recruitment, and sampling weights calibrated to the 2010U.S. Population Census. Hispanic/Latino individuals of Dominican, Central American, South American, Cuban, Mexican, and Puerto Rican background were considered. Cigarette smoking, smoking cessation treatment, and depressive symptoms were measured by self-report. Results indicated that current smokers had greater odds for significant depressive symptoms (CES-D score ≥ 10) than never smokers in all Hispanic background groups [odds ratio (OR) > 1.5]. Depressed persons were not more likely to receive prescribed smoking cessation medications from a doctor (OR = 1.43, 95% CI = 0.98-2.08), take over-the-counter medications (OR = 1.11, 95% CI = 0.75-1.66), or receive psychotherapy (OR = 1.02, 95% CI = 0.57-1.85). In conclusion, these findings suggest that the positive association between smoking status and depressive symptoms is present in all examined Hispanic/Latino background groups

Is Acculturation Related to Obesity in Hispanic/Latino Adults? Results from the Hispanic Community Health Study/Study of Latinos

Background. The study examined the association of obesity with acculturation in a large and diverse sample of US Hispanic/Latino adults. Methods. The Hispanic Community Health Study (HCHS)/Study of Latinos (SOL) is a community-based cohort study of Hispanic/Latino adults aged 18–74 years (N=16,415) from four urban areas. Height and weight were directly measured using a standardized protocol. Acculturation was assessed by the Short Acculturation Scale for Hispanics (SASH). Other immigration related variables included place of birth, length of residency in the US, and age at immigration. Odds ratios were calculated to assess the association of overweight, moderate obesity, and extreme obesity (≥40 kg/m2) with acculturation and sociodemographic variables. Results. The prevalence of obesity was 42.4% for women and 36.5% for men and varied by field center and Hispanic/Latino background. The strongest predictor of moderate and extreme obesity was length of residency in mainland US. This association was consistent across Hispanic/Latino backgrounds. Acculturation was not significantly associated with obesity. Discussion. The burden of obesity is high among Hispanic/Latino adults. The study findings suggest that prolonged exposure to the environments in these communities, rather than acculturation, is an important risk factor for obesity in this population