Hispanic man sitting on a couch

Hispanics/Latinos are rarely aware of a heart-pumping problem in which they suffer at higher rates, according to new research in the American Heart Association’s journal Circulation: Heart Failure.

In the Echocardiographic Study of Hispanics/Latinos, known as ECHO-SOL, about half of the 1,818 middle-aged and older Hispanics/Latinos had cardiac dysfunction. Yet, fewer than one in 20 knew they had it.

Cardiac dysfunction is serious because it can develop into heart failure, a chronic disease in which the heart pumps less blood than the body needs to remain healthy.

“The perception has been that Hispanics/Latinos are a low-risk group for cardiac dysfunction, but that is not true,” said Carlos Rodriguez, M.D., M.P.H., study senior author and associate professor of medicine and epidemiology at Wake Forest Baptist Medical Center in Winston-Salem, North Carolina.

Researchers used ultrasound images of the heart to identify cardiac dysfunction in people ages 45-74 living in the Bronx, Chicago, Miami and San Diego. Among those with high rates of risk factors for cardiac dysfunction:

  • Half were obese;
  • Half had high blood pressure;
  • Two-thirds had diabetes;
  • Two-thirds reported low levels of physical activity;
  • One-fifth were smokers.

These risk factors, along with heart attack, are the same risk factors for progression of cardiac dysfunction to heart failure.

Health professionals should have “a high level of vigilance” in monitoring their Hispanic/Latino patients’ health and a “low threshold for intensifying preventative therapies to avoid the possibility of heart failure down the road,” Rodriguez said.

The earlier the intervention, the better, because some studies have suggested that aggressively reducing risk factors can reverse cardiac dysfunction.

In ECHO-SOL, researchers diagnosed two types of cardiac dysfunction: left ventricular systolic dysfunction and left ventricular diastolic dysfunction. In LVSD, the left ventricle, the heart’s largest chamber, doesn’t push blood out to the body as forcefully as it should. In LVDD, the left ventricle is too stiff when relaxed between beats to gather enough blood in its chamber.

Prevalence of LVDD was particularly high among Latino-Americans from Central America, whose risk was nearly double that of Mexican-Americans. Researchers said that they don’t know whether ancestry or environment explained the difference.

In the only other large study of cardiac dysfunction in the United States, researchers looked at an older, largely non-Hispanic white population and found that about a third had cardiac dysfunction.

Because Hispanics/Latinos have been overlooked in previous studies, there are no reliable estimates of how many with cardiac dysfunction will develop heart failure. Researchers plan to continue following ECHO-SOL participants to begin to answer that question.

“Given that Hispanics/Latinos are the largest ethnic minority in the United States, with over 51 million people, they are likely to have a big impact on the heart failure epidemic,” he said.