Hispanic women face great heart risk

Evelyn Rodriguez is lucky. The woman, who grew up in Paterson but whose family is from Costa Rica, works in the mailroom at St. Joseph's Wayne Hospital, so she saw posters encouraging her to get screened for heart disease. When she did, she found out she needed to improve her cholesterol and exercise more. "I had no idea," she says.

Many Hispanic women are not so fortunate. Fewer than a third know that heart disease is the No. 1 killer of women, according to one study from researchers at Columbia University published in the Journal of Women's Health earlier this year. New studies also show that the risk for Hispanics, once considered surprisingly low, is greater than previously thought and among the highest of all ethnic groups.

The dangerous combination of high risk and lack of knowledge about health has doctors and public health experts worried.

"We thought it was other groups at risk, and now we've got to pay attention to the Hispanic population," says Carolyn Strimike, a nurse practitioner at The Women's Heart Center at St. Joseph's. "This is brand new for us."

Several studies published in the past few years have overturned the conventional wisdom that Hispanics are at lower risk for heart disease. One study, presented at the American Heart Association's annual meeting last spring, showed that Hispanic women tend to develop the risks, including problems with blood pressure, cholesterol levels and diabetes, earlier than white women. The study concluded that Hispanic women, on average, have the same severity of risk as white women 10 years their senior.
Another study, of more than 2,000 patients in San Antonio who were followed by researchers for 15 years, showed that Mexican-Americans were more likely to die of heart disease than whites. The study theorized that miscounting, rather than a healthier population, accounted for the erroneous assumption of better health.

Though no one is quite sure why Hispanics develop heart disease risks earlier, experts have attributed it to a starch-filled diet, relative lack of exercise and attitude that heart disease cannot be prevented. "The Latino-Hispanic community is more likely than the non-Hispanic white population to believe that disease is a normal and unavoidable part of life," conclude researchers in an article in the medical journal Endocrine Practice.

In response to these and similar findings, a glut of public health initiatives -- from Spanish-language informational flyers to risk-screenings targeted at Hispanics to a major study by the National Institutes of Health -- have been launched to both educate this population and prevent it from developing the disease.

After heart valve problems several years ago, Carmen Ortega, a nurse at St. Joseph's Regional Medical Center in Paterson, had a screening at St. Joseph's Women's Heart Center. There, she learned she was in danger of developing diabetes, a major red flag that can speed the occurrence of heart disease.

"It upset me," she says. "Being in the health profession, you tend to think it can happen to others and not yourself."

Ortega has begun to change her health habits. "I'm trying to walk every day at least 30 minutes," she says. "I'm at least walking up and down stairs," rather than taking the elevator.

She's also changing her diet, though that's been hard. Her family is from Puerto Rico. "They love rice, and they eat a lot of fried foods," she says. Before, "at least every day, I would eat rice. I eat it three times a week now and try to put in more vegetables."

Rodriguez, too, says her culture's food is not always heart-healthy. "I'm Spanish," she says. "I cook rice-and-beans every day. I love meat."

But rice is toxic for a heart-healthy diet, says Dr. Elliot Brown, a cardiologist at St. Mary's Hospital in Passaic. "Rice is like eating a candy bar, as far as your digestive tract is concerned," because it has such a high level of sugar. Brown tries to encourage his patients to eat long grain or brown rice, he says.

Brown also experiences Hispanics' relative lack of risk-awareness first-hand. He often sees Hispanic patients only after they have developed severe heart disease. Because of that, he says, teaching prevention is very difficult. He attributes the late realization to a lack of education, lack of health insurance or language barriers.

At the heart center, nurses scramble to break down those barriers. They've just begun outreach programs to screen at churches and put information in Spanish on their Web site, says Strimike. "We weren't seeing the Hispanic population" at events aimed at the general population, she says.

The specific targeting of Hispanic women seems to be working. Many, Strimike says, react as Rodriguez did: Surprise that it could happen to them.

"So many times when they come in they haven't thought about their risk factors at all," she says. "It's brand new information for them."

source : www.northjersey.com