Having health insurance is a key predictor of whether Hispanics at high risk for heart disease use cholesterol-lowering medications known as statins, according to new research in the Journal of the American Heart Association.

It is one of the first studies to document differences in the use of widely prescribed statins and aspirin among diverse Hispanic and Latino populations in the United States.

“These findings have important implications for preventing disparities in cardiovascular outcomes within the growing U.S. Hispanic/Latino population,” said lead author Dima M. Qato, assistant professor of pharmacy systems, outcomes and policy at the University of Illinois in Chicago. “Efforts to increase the use of statins, particularly targeting individuals that have already suffered a heart attack or stroke, should include expanding health insurance for all Hispanic/Latino adults that currently lack coverage, regardless of their heritage.”

Investigators found statin use was highest among high-risk study participants of Puerto-Rican heritage at 33 percent followed by those of Dominican heritage at 28 percent. The range was 22 percent for participants of Cuban and South American heritage and lowest among those of Central American backgrounds at 20 percent. But the lack of health insurance was associated with a lower likelihood of statin use in all groups.

Results were from 4,139 patients at high risk for heart disease enrolled in the larger Hispanic Community Health Study/Study of Latinos, in the Bronx, New York; Chicago, Illinois; Miami, Florida; and San Diego, California. The study was conducted between March 2008 and June 2011.

All participants, who had the average age of 52 and half of whom were women, were at high risk for heart disease – defined in the study as ever having had a heart attack, stroke or diabetes. At enrollment, participants underwent medical examinations and answered questionnaires about medication use and heart disease history.

Overall, researchers noted that one-fourth of participants took statins and less than half, 44 percent, took aspirin. The use of over-the-counter aspirin was comparable among all Hispanic/Latino groups.

“Efforts to improve statin prescribing in patients likely to benefit are particularly important in patients with history of heart disease,” Qato said. “Healthcare providers and policy makers should be aware of the role of insurance in the underuse of preventative cardiovascular medications in specific Hispanic/Latino populations.”

Heart disease is the No. 1 killer for all Americans and stroke is the fifth-leading cause of death. Hispanics and Latinos, however, face even higher risks of cardiovascular diseases because of high blood pressure, obesity and diabetes.

In a study presented in November at the AHA’s Scientific Sessions conference, researchers found that although 32 percent of Hispanic adults were eligible for statin therapy under the 2013 American College of Cardiology/AHA  treatment guidelines, just 10 percent were being treated.

In addition to medication, when necessary, the AHA promotes the lifestyle changes in its Life’s Simple 7 — controlling cholesterol, managing blood pressure and blood sugar, getting active, eating better, losing weight, and quitting smoking— to lower cardiovascular risks.