Hispanic-Americans need a culturally tailored approach to improve their heart health, according to an American Heart Association statement — the first to describe the burden of heart disease and stroke among the diverse population with origins in Mexico, Puerto Rico, Cuba, the Dominican Republic and Central and South America.

A diverse population, Hispanics carry a heavy burden of heart disease and stroke.

Recent studies have shown that Mexican-Americans are twice as likely as whites to have an ischemic stroke before age 60 and have significantly more hospitalizations for heart attacks than whites. Meanwhile, research shows that the longer Hispanic immigrants live in America, the higher their risk for obesity, diabetes and high blood pressure—all significant risk factors for heart disease and stroke.

Yet there is a wide gap in knowledge about the risks and toll of cardiovascular diseases among Hispanic-Americans, said Carlos Rodriguez, M.D., M.P.H., lead author of the statement published Monday in the journal Circulation, and a cardiologist at Wake Forest Baptist Medical Center in Winston-Salem, N.C.

“This segment of the population has been somewhat ignored,” said Rodriguez. “Given the large Hispanic population in the U.S., it would be very hard to achieve great health metrics for the nation if this population is left behind.”

More than 53 million Hispanics live in the U.S. today, making up 17 percent of the total population. By 2050, the Hispanic-American population is expected to grow to nearly 133 million or 30 percent of the total population.

Heart disease is the No. 1 cause of death for Hispanic-Americans, just as for the rest of the population. But Hispanics are much less aware of this danger — and their own personal risk factors — than whites.

The statement calls for customized approaches to improve heart health and facilitate the acceptance of treatments to prevent or treat cardiovascular disease among Hispanic-Americans. Healthcare providers, researchers and policymakers must consider cultural values and beliefs, language, the impact of acculturation and other factors when developing such strategies.

Rodriguez, a Dominican, said a big problem among healthcare providers and researchers has been a lack of appreciation for the diversity and complexity of Hispanic-Americans based on their country of origin. “I hear a lot about cardiovascular risk in Hispanic-Americans and it doesn’t quite fit with what I see in my community from the Dominican Republic,” he said, noting that most of the research done so far has focused on Mexican-Americans.

Recommendations for improving cardiovascular health in Hispanic-Americans include:

  • Train healthcare providers to provide culturally proficient health care to Hispanic Americans;
  • Standardize health research, electronic health records and other surveillance systems to include Hispanic subgroups based on countries of origin;
  • Increase the Hispanic healthcare workforce, including Spanish-speaking physicians;
  • Put into practice educational programs to help Hispanic-Americans recognize risk factors and warning signs of stroke and heart attack;
  • Implement effective heart health promotion and disease prevention strategies within Hispanic communities and public schools.

“We need to embrace the Hispanic population and include them in the cardiovascular health goals we have for the entire country,” said Rodriguez.