25 Jun Hispanics Have High Prevalence of Hyperlipidemia, but Low Awareness and Treatment
MedicalResearch.com Interview with:
Carlos J. Rodriguez, MD, MPH
Division of Public Health Sciences
Department of Medicine Wake Forest School of Medicine
Winston‐Salem, NC 27152
MedicalResearch: What prompted you to study cholesterol in the Latino population? Please explain in detail.
Dr. Rodriguez: Early in my career I noted that there were race-ethnic differences in the cholesterol profile between hispanics, african americans and non-hispanic whites. Hispanics are the largest ethnic minority group in the us yet prior studies of cholesterol in hispanics were relatively small, lacked adequate representation of diverse hispanic background groups for comparisons, and were not necessarily representative of nor generalizable to the hispanic population. The hispanic/latino adults in the hispanic community health study / study of latinos helped filled this critical gap.
MedicalResearch: What do you think are the most significant findings from your study? What could have the greatest clinical implications and applications?
Dr. Rodriguez: Several findings are important: less than half of those with high cholesterol were aware of their condition; less than a third of those with high cholesterol were being treated; and among those receiving treatment, only two-thirds had cholesterol concentrations that were adequately controlled.
MedicalResearch: Why do you think Latinos have this high risk for hyperlipidemia? Is it diet? Genes? A mix? Please explain in detail.
Dr. Rodriguez: Hispanics have a high prevalence of high cholesterol (approximately 45%) due probably a mix of genes and diet. What is more surprising is the lack of awareness, treatment and control that needs to change since awareness is the first step in prevention; one cannot actively prevent what one is not aware of.
MedicalResearch: Half reported not being aware of their condition, meaning that a healthcare professional never informed them of their elevated cholesterol. Do you think this reflects a problem in the US healthcare industry or do you think this was an issue with recall? Please explain in detail.
Dr. Rodriguez: Of course some component may be recall bias but I don’t think that’s the major component to this finding. When such a large percentage of the population has not had a health professional tell them about high cholesterol, I think that is a problem on several levels with the health care system including issues with access to care and patient-provider difficulties such as language barriers or cultural insensitivity.
MedicalResearch: WHY do you think younger people, women and undereducated an underinsured were less likely to have their cholesterol controlled? And why do you think certain groups such as Puerto Ricans had better treatment that Mexicans? What’s driving these disparities and how could they be corrected?
Dr. Rodriguez: I think much of it is access to care related where certain groups such as young hispanics and latinas may be falling through the cracks in the health care system but some of the reason is also physician inertia where one may be reluctant or just more slow to uptitrate or intensify treatment in certain patients. Patient adherence is also a significant factor low due to lack of understanding, lack of resources to get their medications or patient provider relationship difficulties such as language barriers or cultural insensitivity.
MedicalResearch: You studied primarily urban communities. Do you think the same would hold true for rural communities or perhaps be even worse? Please explain in detail.
Dr. Rodriguez: Yes. Rural communities would do possibly worse or similar.
MedicalResearch: What do you think is the most important take-away message to people reading your study?
Dr. Rodriguez: An important message is that no population can be left behind if we are to improve the health of the nation. Our study highlights that the hispanic population needs attention with regards to cholesterol awareness, treatment and control.
MedicalResearch: Based on these findings, what do you plan to study next?
Dr. Rodriguez: I think further studies on how acculturation impacts health are needed. This is important primarily for immigrant populations such as hispanics. I also think more studies that can pilot an intervention to address improving health literacy, cultural competency, and assessing how these interventions impact physician inertia or patient adherence. Also we need to evaluate if more widespread acceptance of the affordable care act across all states helps alleviate any of the findings from this study.
Citation:
J Am Heart Assoc. 2015;4:e001867, originally published June 24, 2015, doi:10.1161/JAHA.115.001867
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Carlos J. Rodriguez, MD, MPH, Division of Public Health Sciences, Department of Medicine Wake Forest School of Medicine, Winston‐Salem, NC 27152 (2015). Hispanics Have High Prevalence of Hyperlipidemia, but Low Awareness and Treatment
Last Updated on June 26, 2015 by Marie Benz MD FAAD