Stroke Among Hispanics
Excerpted from "Salud es Vida — Health is Life," Stroke Connection Magazine, September/October 2004
According to the U.S. Census Bureau, the Hispanic population has increased by 34 percent since 1980. The term Hispanic is a generic term used to describe various cultures from a variety of countries. Even though they share a language, there are many distinct subgroups: Mexican Americans (62 percent), Puerto Ricans (13 percent), Cuban Americans (5 percent), Central and South Americans (12 percent) and other Hispanics (8 percent). Almost three-quarters of all Hispanics live in California, Texas, New York, Florida, New Jersey and Illinois.
Hemorrhagic Strokes Are More Common
Stroke is the fourth-leading cause of death among Hispanics. Studies indicate that they have a higher rate of hemorrhagic strokes at a younger age than non-Hispanic whites. One study found that hemorrhagic strokes occurred more commonly in Hispanics than in any other sub-group.
Different Prevalence of Risk Factors
Hispanics have a different prevalence of risk factors for stroke when compared with non-Hispanic whites. For instance, they have strokes at younger ages. The Northern Manhattan Stroke Study, a large, urban stroke investigation, found that the average age for stroke in Hispanics was 67 compared to 80 for non-Hispanic whites. Other findings include:
- Diabetes is more prevalent among Hispanics, with estimates that 30 percent of adults have the disease, and as many as half do not know. The prevalence of previously diagnosed diabetes in Mexican Americans and Puerto Ricans between ages 24–74 was 2.4 times greater than in non-Hispanic whites.
- The Barrow Neurological Institute Stroke Database found that Hispanics have the greatest proportion of hypertension. It was found in 72 percent of Hispanics with stroke (66 percent in non-Hispanic whites).
- The Northern Manhattan Stroke Study found that Hispanics in general are less likely to have cardiac disease — 32 percent compared to 61 percent for non-Hispanic whites.
- Several studies indicate high alcohol use among Hispanics. Heavy alcohol use occurs in 40 percent of Latino men age 18–39, and the Barrow Database found that 24 percent of Hispanics have heavy alcohol intake compared to 17 percent in non-Hispanic whites.
- Obesity is more prevalent among Hispanics than among non-Hispanic whites. The American Heart Association reports that 75 percent of Mexican-American men and 72 percent of women age 20 and older were overweight or obese and 29 percent of men and 40 percent of women were obese.
- The National Health and Nutrition Examination Survey reported that 65 percent of Mexican-American men and 74 percent of Mexican-American women did not participate in leisure-time physical activity.
- Hispanics are less likely than non-Hispanic whites to have health insurance (66 percent vs. 89 percent) and more likely to have diseases associated with income (hypertension, diabetes, obesity and alcohol abuse). The uninsured rate of Hispanics is three times that of non-Hispanic whites.
- Language barriers and lack of transportation contribute to poor access to healthcare providers. Because of this, Hispanics are more likely to delay care, drop out of treatment when symptoms disappear and have poor rates of physician and dentist use. Because of these differences in risk factors as well as cultural and language differences, stroke education in the Hispanic population requires new messages that focus on diabetes, hypertension and weight control. Stroke causes the death of one in four Hispanic males and one in three Hispanic women. If our society is to change those numbers, clearly we must learn to speak the language of stroke in Spanish.
People with the metabolic syndrome are at increased risk for developing diabetes and cardiovascular disease. A person has the metabolic syndrome if they have three or more of the following abnormalities:
- Waist circumference greater than 40 inches in men and 35 inches in women.
- Trigylceride level of 150 mg/dL, or higher
- HDL cholesterol level less than 40 mg/dL in men and 50 mg/dL in women
- Blood pressure of 130/85 mm Hg or higher
- Fasting glucose level of 110 mg/dL or higher.
Researchers estimate that 47 million Americans have the metabolic syndrome. Risk increases with age. Age-adjusted prevalence for adults is 23.7 percent. Mexican Americans have the highest prevalence at 31.9 percent. If you have three or more of these conditions or have a brother, sister or parent with diabetes, you should be tested regularly for diabetes. In addition, experts recommend that all adults over age 45 should have a fasting blood glucose test every three years, and more often if they have several risk factors.
Source: Topics in Stroke Rehabilitation, Winter 2003.