Cardiovascular Disease Mortality Among Hispanic Versus Non-Hispanic White Adults in the United States, 1999 to 2018

Safi U. Khan, Ahmad N. Lone, Siva H. Yedlapati, Sourbha S. Dani, Muhammad Zia Khan, Karol E. Watson, Purvi Parwani, Fatima Rodriguez, Miguel Cainzos-Achirica, Erin D. Michos

Research output: Contribution to journalArticlepeer-review


BACKGROUND: Life expectancy has been higher for Hispanic versus non-Hispanic White (NHW) individuals; however, data are limited on cardiovascular disease (CVD) mortality. METHOD AND RESULTS: Using the Centers for Disease Control and Prevention’s Wide-Ranging Online Data for Epidemiologic Research death certificate database (1999–2018), we compared age-adjusted mortality rates for total CVD and its subtypes (ischemic heart disease, stroke, heart failure, hypertensive heart disease, other CVD), and average annual percentage changes among Hispanic and NHW adults. The age-adjusted mortality rate per 100 000 was lower for Hispanic than NHW adults for total CVD (186.4 versus 254.6; P<0.001) and its subtypes. Between 1999 and 2018, mortality decline was higher in Hispanic than NHW adults for total CVD (average annual percentage change [AAPC], −2.90 versus −2.41) and ischemic heart disease (AAPC: −4.44 versus −3.82) (P<0.001). In contrast, stroke mortality decline was slower in Hispanic versus NHW adults (AAPC: −2.05 versus −2.60; P<0.05). Stroke mortality increased in Hispanic but stalled in NHW adults since 2011 (AAPC: 0.79 versus −0.09). For ischemic heart disease (AAPC: −0.80 versus −1.85) and stroke (AAPC: −1.32 versus −1.43) mortality decline decelerated more for Hispanic than NHW adults aged <45 years (P<0.05). For heart failure, Hispanic adults aged <45 (3.55 versus 2.16) and 45 to 64 (1.88 versus 1.54) showed greater rise in age-adjusted mortality rate than NHW individuals (P<0.05). Age-adjusted heart failure mortality rate also accelerated in Hispanic versus NHW men (1.00 versus 0.67; P<0.001). CONCLUSIONS: Disaggregating data by CVD subtype and demographics unmasked heterogeneities in CVD mortality between Hispanic and NHW adults. NHW adults had greater CVD mortality rates and slower decline than Hispanic adults, whereas marked demographic differences in mortality signaled concerning trends among the Hispanic versus NHW population.

Original languageEnglish (US)
Article numbere022857
JournalJournal of the American Heart Association
Issue number7
StatePublished - Apr 5 2022


  • Hispanics
  • cardiovascular mortality
  • epidemiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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