Study Finds Hispanic, Latino Populations Underuse Cardiovascular Medication

Simin Hua, MHSc

A recent analysis of Hispanic and Latino patients in the US is shedding new light on an unsettling trend in regard to cardiovascular health.

Results of the analysis indicated recommended medications for peripheral artery disease and coronary artery disease, including antihypertensives, antiplatelet, and lipid-lowering therapies, were being severely underused in these populations.

“Heightened attention and more efforts to improve treatment are needed in the care of PAD patients to prevent future cardiovascular events and leg amputation,” said lead investigator Simin Hua, MHSc, an associate researcher in the department of epidemiology and population health at Albert Einstein College of Medicine in New York City, in a statement. “These efforts might include improving health care access, educating patients and advocating that physicians offer guideline-adherent treatment. This is especially important because many Hispanic/Latino individuals in the U.S. face issues such as lack of health insurance and high burden of cardiovascular risk factors.”

To further explore the underuse of cardiovascular medications for secondary prevention in Hispanic or Latin patients with peripheral artery disease, Hua and a team of investigators designed their study using data from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). From the HCHS/SOL, which is an ongoing community-based study, investigators obtained information related to more than 16,000 patients from multiple sites across the US, including 1244 who were included in the current study.

The 1244 patients included in the current study were recruited from sites in Bronx, NY, Chicago, IL, Miami, FL, and San Diego, CA. Of the 1244 patients included in the study cohort, 826 reported a peripheral artery disease diagnosis at baseline and 418 reported coronary artery disease alone. During the baseline examination for the study, all participants were asked to bring in medication they had taken over the past 4 weeks.

Of note, multivariable regression models used in the analyses accounted for demographic and socioeconomic factors, acculturation, access to health care, and comorbidities.

Results of the investigators’ analyses indicated underuse of antiplatelet, lipid-lowering, and antihypertensive therapies among patients with peripheral artery disease. Specifically, 31% reported use of antiplatelet therapy, 26% reported use of lipid-lowering therapy, and 57% reported use of antihypertensive therapy.

Additionally, results suggested older age, increased number of doctor visits, and existing hypertension and diabetes were significantly associated with taking cardiovascular medications in adjusted models. Investigators noted those with concurrent coronary artery disease were 1.52-times (HR, 1.52; 95% CI, 1.20-1.93) more likely to report use of antiplatelet agents and 1.74-times (HR, 1.74; 95% CI, 1.30-2.32) more likely to report use of statins when compared to patients with peripheral artery disease alone.

Investigators highlighted there were significant differences found in use of antihypertensive mediation among patients with peripheral artery disease alone and those with concurrent coronary artery disease. Investigators also pointed out patients with a Mexican background reported lower rates of use across cardiovascular medications included in the study and an 11-18% higher rate of medication use, on average, among people with health insurance coverage compared to those without.

“The need for medications did not seem to receive the same level of attention for patients with PAD compared to those with coronary artery disease, even though both patient groups can benefit from these cardiovascular medications,” Hua added, in the aforementioned statement.

This study, titled “Underuse of Cardiovascular Medications in Individuals With Known Lower Extremity Peripheral Artery Disease: HCHS/SOL,” was published in the Journal of the American Heart Association.