Cardiovascular disease surpasses cancer as top killer of Hispanic populations in the U.S.

Hispanic people represent nearly 1 in 5 of the U.S. population and are the nation's largest ethnic minority group, yet many continue to face barriers to achieving heart health and accessing high quality healthcare. The statement also highlights important differences among Hispanic populations, including those born in the U.S. versus other countries and even among specific Hispanic heritage backgrounds, including those of Mexican, Puerto Rican, Cuban, Dominican, Central American and South American descent.

That's why the chair of the scientific statement's volunteer writing group, Johanna Contreras, M.D., M.Sc., FAHA, cautions that there is no one-size-fits-all approach to heart health for Hispanic communities.

Hispanic cardiovascular health by the numbers

Cardiovascular risk factors are highly prevalent among Hispanic adults and often emerge at younger ages and occur more frequently among Hispanic adults compared with white adults.

• Nearly 46% of Hispanic adults have obesity, with the highest rates reported among Puerto Rican and Dominican heritage groups.
• Type 2 diabetes affects 15.5% of Hispanic adults, nearly twice the prevalence among white adults. Prevalence is highest among Mexican and Puerto Rican individuals.
• About 44% of Hispanic adults have high blood pressure, yet awareness, treatment and control rates remain lower than among white adults. The highest prevalence is observed among Puerto Rican, Cuban and Dominican individuals.

This high prevalence of cardiovascular risk factors drives increased cardiovascular disease among Hispanic adults, often occurring at younger ages. Disparities exist between Hispanic adults and white adults, and between U.S.-born and foreign-born Hispanic individuals.

• Hispanic adults are diagnosed with heart failure about 8 to 9 years younger than white adults.
• Hispanic adults, on average, experience a first stroke about 6 to 8 years younger - 67 years old compared to 73 to 75 years old among white adults.
• U.S.-born Hispanic adults have shorter life expectancy and higher death rates than their foreign-born counterparts, driven by high prevalence of heart disease, stroke and multiple cardiovascular disease risk factors.

• Dietary quality remains a challenge. Fewer than 2% of Hispanic adults meet recommended sodium intake goals, and fewer than 10% meet recommendations for healthy fats. Increased intake of ultraprocessed foods and sugar sweetened beverages is more commonly observed among U.S.-born Hispanic adults.
• Approximately one-third of Hispanic adults report getting less than seven hours of sleep per night, a factor linked to obesity, diabetes and high blood pressure. Short sleep duration was most prevalent among individuals of Puerto Rican background.
• Nearly one-third of Hispanic adults report no moderate-to-vigorous leisure-time physical activity, the highest rate among all U.S. racial and ethnic groups.

Social and economic barriers matter

The writing group emphasized that biology alone does not explain cardiovascular health disparities. The environments where people live, work and age, along with social and economic challenges, can have a profound impact on heart health.

"Many Hispanic adults face obstacles that extend far beyond the doctor's office," Contreras said. "Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment. These challenges accumulate over time and contribute to persistent inequities in cardiovascular health."

According to the report:

• Approximately 17% of Hispanics live below the federal poverty threshold compared with 8.2% of white adults and they earn less at comparable education levels.
• About 41% of all Hispanic adults and 66% of older Hispanic adults have low or limited health literacy compared with 9% of white adults. This significantly impacts how they understand medical information and work within healthcare systems to get care.
• Approximately 20% of Hispanic adults remained uninsured in 2023, compared with 6.4% of white adults and 9.8% of Black adults. This creates significant challenges for prevention and treatment.

Contreras emphasized that the rich cultural values and practices of Hispanic people also greatly influence how they may perceive their health and healthcare options.

"Family plays a central role in many Hispanic communities and can be an extraordinary source of strength, support and resilience," Contreras said. "At the same time, family members are often called upon to translate medical information, navigate health systems and help make healthcare decisions for loved ones. Those responsibilities can shape how health information is understood and acted upon. While trusted family and community networks are invaluable, they can also become pathways for health misinformation, making culturally relevant and accurate health communication critically important."

An action plan for improving Hispanic health

The scientific statement provides an in-depth look at the factors shaping cardiovascular health among Hispanic populations in the U.S., from traditional risk factors to the social and structural barriers that influence health. Beyond documenting the challenges, the statement outlines practical opportunities to achieve equitable cardiovascular health and reduce disparities through community engagement, culturally responsive care, inclusive research and policies that address the underlying drivers of health.

Considerations include:

• Trusted community partnerships in settings such as churches, markets, community centers and Spanish-language media platforms to help meet people where they live, work and play.
• Improved access to care and tailored clinical care including culturally appropriate bilingual health education and increased use of community health workers;
• Increased representation of Hispanic people in research studies including those using artificial intelligence and collecting more detailed data about different Hispanic heritage groups so researchers and clinicians can better understand and address unique health needs;
• Greater attention to the social conditions and policies that shape health.

"Raising awareness about these disparities is important, but awareness without access is not enough," Contreras said. "Reducing cardiovascular disease among Hispanic populations demands action at every level, from improving access to culturally responsive care and expanding research participation to addressing the social and environmental conditions that shape health. A person's ZIP code, access to healthy foods, ability to communicate with healthcare providers and opportunities to be physically active can be just as important to heart health as traditional medical risk factors."

As the Hispanic population continues to grow and age, improving cardiovascular health in these communities will be critical to the nation's overall health. The statement authors emphasize that meaningful progress will require collaboration among healthcare systems, researchers, policymakers, community organizations and families to ensure that every person has access to prevention, treatment and support that reflects their culture, language and lived experiences. By addressing both medical risk factors and the social conditions that shape health, experts believe there is an important opportunity to reduce disparities and help more people live longer, healthier lives.

Source:

American Heart Association

Journal reference: