Circulation, Vol 83, 45-51, Copyright © 1991 by American Heart Association
BD Mitchell, HP Hazuda, SM Haffner, JK Patterson and MP Stern
Mexican-American men experience reduced cardiovascular mortality compared
with non-Hispanic white men. There is no corresponding ethnic difference in
cardiovascular mortality in women. The difference in men could result
either from a lower incidence of cardiovascular disease or a lower case
fatality rate among Mexican-Americans. Although the incidence of
cardiovascular disease in Mexican-Americans is unknown, we have collected
data on prevalence of myocardial infarction in 5,148 individuals examined
in the San Antonio Heart Study, a population-based survey of cardiovascular
disease conducted between 1979 and 1988 in Mexican-Americans and
non-Hispanic whites aged 25-64 years. Myocardial infarction was assessed by
Minnesota-coded electrocardiograms and by a self-reported history of a
physician-diagnosed heart attack. For both end points, the age-adjusted
prevalence of myocardial infarction was lower in Mexican-American men than
in non-Hispanic white men. After adjustment for age and diabetes status
(present/absent), the odds of a myocardial infarction, as defined by either
criterion, was approximately one third lower in Mexican-American men than
in non- Hispanic white men (p = 0.06). In women, the prevalence of both
myocardial infarction end points was slightly higher in Mexican- Americans
than in non-Hispanic whites, although neither of these differences was
significant. Although the ethnic differences in prevalence in this study
were not statistically significant, their pattern parallels the pattern in
the mortality due to cardiovascular diseases. Therefore, the results
support the hypothesis that the reduced cardiovascular mortality rate
observed in Mexican-American men reflects a lower incidence of myocardial
infarction rather than a reduced case fatality rate because the latter
would result in a higher prevalence.
ARTICLES
Myocardial infarction in Mexican-Americans and non-Hispanic whites. The San Antonio Heart Study
Department of Medicine, University of Texas Health Science Center, San Antonio 78284.
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