Hispanic People at Risk for Heart Disease Going Untreated
THURSDAY, March 4, 2021 (HealthDay News) – Even after suffering a stroke, many Hispanic Americans still suffer from uncontrolled diabetes, high blood pressure or other conditions that increase their risk of recurrence, according to a new study.
The study involved 404 Hispanic adults with a history of stroke or “mini-stroke,” which is a brief reduction in blood flow to the brain that can herald a full-blown stroke. The researchers found that despite these fears, few patients had their stroke risk factors under control.
Awareness didn’t seem to be the problem: most patients with high blood pressure, high cholesterol, or diabetes knew it.
Still, many did not have these conditions under good control, according to the study.
“This shows that we have work to do,” said lead researcher Dr. Fernando Testai, associate professor of neurology at the University of Illinois at Chicago. “It’s a wake-up call for the medical community.”
The study, published online March 4 in the journal Stroke,is not the first to discover a high prevalence of heart and vascular disease risk among American Hispanics.
According to the American Heart Association, more than half of Hispanic men and about 43% of Hispanic women in the United States suffer from some form of cardiovascular disease.
The new study focused on a group of patients who, due to their history of stroke, should ideally be in tight control of conditions such as high blood pressure and diabetes.
This was not the case, however.
“We found that less than half of the patients who knew they had high blood pressure got their numbers where we would like them to be,” Testai said.
Meanwhile, only a third of people with known high cholesterol had lowered those numbers, according to the results. And of those patients who knew they had diabetes, just over half had good disease control.
The precise reasons are not clear. But many patients were not taking standard drugs: about half were taking anti-clot drugs; even fewer were on cholesterol-lowering statins.
Testai pointed out some of the study’s great models.
Older patients, for example, were less likely to control their hypertension or diabetes. This could indicate issues with adherence to medication or lifestyle advice, speculated Testai, or perhaps substandard health care compared to younger patients.
Additionally, patients who lived in the United States longer tended to have poorer diabetes control.
One potential explanation is that these patients were more exposed to the typical American diet and the abundance of calories from processed foods, Testai said.
Dr José Biller, professor of neurology at Loyola University in Chicago, agreed.
“Dietary changes are often attributed to acculturation, and food is often used as a metaphor for citizenship,” said Biller, who is also a volunteer expert with the American Heart Association / American Stroke Association. “We are what we eat. Everyone benefits from reduced salt intake, staying active and maintaining a healthy lifestyle.”
Biller also said patients may face “critical” barriers that make it difficult to comply with medications, ranging from cost and coexisting medical conditions to their own beliefs about medications.
In some cases, Testai said, language can be a barrier. If doctors need to communicate through a translator, it can make it more difficult to build a strong provider-patient relationship, he explained.
Communication is essential, Biller agreed. He added that healthcare providers need “cultural skills” and skills to “actively listen and not talk to patients”.
On a larger scale, Biller said, people living in communities that are “health care deserts” need better access to quality care.
As for what patients can do, Testai focused on diet changes, exercise, and, if necessary, weight loss.
“Medicines are only part of the story,” he said. “It’s the sedentary lifestyle. It’s the diet.”
Testai pointed out that people don’t need a gym membership to exercise. Getting physical activity throughout the day is what matters.
“Get out there and walk around the block,” he says. “Take the stairs instead of the elevator. It’s about changing the general lifestyle.”
The American Stroke Association has more on stroke prevention.
SOURCES: Fernando Testai, MD, PhD, associate professor, neurology, University of Illinois at Chicago; José Biller, MD, professor and president, neurology, Loyola University of Chicago, Stritch School of Medicine, Maywood, Illinois, and volunteer expert, American Heart Association / American Stroke Association, Dallas; Stroke, March 4, 2021, online
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