Portal de Periódicos da CAPES

Regarding “Controversies and evidence for cardiovascular disease in the diverse Hispanic population”

2018; Elsevier BV; Volume: 67; Issue: 5 Linguagem: Inglês

10.1016/j.jvs.2017.12.040

1097-6809

Carlos A. Hinojosa, Javier E. Anaya‐Ayala, Julio Granados,

Primary Care and Health Outcomes

We read with great interest the recent study published by Shaw et al1Shaw P.M. Chandra V. Escobar G.A. Robbins N. Rowe V. Macsata R. Controversies and evidence for cardiovascular disease in the diverse Hispanic population.J Vasc Surg. 2017 Sep 23; ([Epub ahead of print])Google Scholar consisting of a systematic search of the literature to identify English-language publications with the terms "cardiovascular disease," "prevalence," "vascular," and "Hispanic," with additional searches including countries such as Mexico, Cuba, and Puerto Rico and geographic regions such as Latin America, and we congratulate the valuable effort. As the authors well said, it is difficult to consider the Hispanic population as a single group because people living in Latin American countries and in the United States with Hispanic ancestry are racially diverse, being predominantly "mestizos" as a result of the miscegenation of the native Americans with Europeans since the 16th century and the subsequent arrival of African populations in the following centuries to certain regions of the New World. A country such as Mexico is one of the best examples of the cultural and genetic mixture of Amerindians and the European colonizers in Latin America.2Moreno-Estrada A. Gignoux C.R. Fernández-López J.C. Zakharia F. Sikora M. Contreras A.V. et al.Human genetics. The genetics of Mexico recapitulates Native American substructure and affects biomedical traits.Science. 2014; 344: 1280-1285Crossref PubMed Scopus (343) Google Scholar In our institution, we study the prevalence of vascular diseases in the Mexican population and particularly of aortic aneurysms and possible genetic risk factors. The authors mentioned that abdominal aortic aneurysms are significantly lower in Hispanics in comparison to other ethnic groups, citing the Life Line Screening sample of 23,466 individuals with a prevalence of 0.86%.3Kent K.C. Zwolak R.M. Egorova N.N. Riles T.S. Manganaro A. Moskowitz A.J. et al.Analysis of risk factors for abdominal aortic aneurysm in a cohort of more than 3 million individuals.J Vasc Surg. 2010; 52: 539-548Abstract Full Text Full Text PDF PubMed Scopus (468) Google Scholar Although this fact is possible, we believe that one of the important shortcomings of this publication is that this study is limited to English-language literature and PubMed searches. There are studies from Spanish-speaking countries such as Argentina4Poveda A.G. Rojas D.A. Detección temprana de aneurismas de la aorta abdominal mediante escáner dúplex a color.Rev Med. 2007; 15: 61-67Google Scholar and Colombia5Maris-Batallés S. Capomasi M. Longo G. Pezzotto S.M. Villavivencio R. Prevalencia de aneurisma de aorta abdominal evaluada con ecografía aórtica y factores de riesgo cardiovascular.Rev Argent Radiol. 2006; 70: 285-288Google Scholar reporting a prevalence ranging from 5.26% to 5.4% and from Brazil, a Portuguese-speaking country, with 2.1%.6Souto F. Pontes S. Taylor M.A. Roelke L. Sandri J. de Melo Jacques C. et al.Rastreamento do aneurisma da aorta abdominal na populaçao da cidade de Vitória (ES).J Vasc Bras. 2005; 4: 59-65Google Scholar In October 2015, we launched in our department an ultrasound screening program for the detection of abdominal aortic aneurysms in populations at risk (smokers, age >65 years, history of dyslipidemias and arterial hypertension), finding a prevalence until now of 3.26% among 1042 patients.7Aneurisma aórtico.http://www.incmnsz.mx/opencms/contenido/aneurisma/Date accessed: December 4, 2017Google Scholar In addition, we performed an intentional search of aortic aneurysms, reviewing systematically 4809 tomographic studies completed in our institution from January 2015 to December 2016, finding a total 271 (5.63%) aortic aneurysms. These programs and studies have had an impact on aortic aneurysm awareness among other specialties in our health system, increasing our referral.8Hinojosa C.A. Anaya-Ayala J.E. Bermúdez-Serrato K. Leal-Anaya P. Laparra-Escareno H. Torres-Machorro A. Predictive value of computed tomographic screening of aortic aneurysms in the Mexican population older than 55 years.Gac Med Mex. 2017; 153: S27-S33PubMed Google Scholar Contrary to previous reports, it seems that aneurysmal disease in Hispanics or Latin American countries is not as uncommon as previously thought, seeking an opportunity to develop research programs and to encourage communication and collaboration among institutions. Finally, we agree with the authors that a better understanding of the cultural and racial diversity of the Hispanic population inside and outside the United States is crucial in terms of establishing preventive measures and appropriate treatment. The literature remains limited, and further well-designed studies are warranted to better understand vascular disease and treatment outcomes in this representative group. Controversies and evidence for cardiovascular disease in the diverse Hispanic populationJournal of Vascular SurgeryVol. 67Issue 3PreviewHispanics account for approximately 17% of the U.S. population. They are one of the fastest growing racial/ethnic groups, second only to Asians. This heterogeneous population has diverse socioeconomic conditions, making the prevention, diagnosis, and management of vascular disease difficult. This paper discusses the cultural, racial, and social aspects of the Hispanic community in the United States and assesses how they affect vascular disease within this population. Furthermore, it explores risk factors, medical and surgical treatments, and outcomes of vascular disease in the Hispanic population; generational evolution of these conditions; and the phenomenon called the Hispanic paradox. Full-Text PDF Open ArchiveReplyJournal of Vascular SurgeryVol. 67Issue 5PreviewWe have read with interest the well-written letter to the Editor regarding our publication "Controversies and evidence for cardiovascular disease in the diverse Hispanic population." Dr Hinojosa and colleagues correctly identify the difficulties in obtaining accurate information on the diverse Hispanic population. The basis of our review was not limited to the English literature but also included articles that were translated to English originally published in Spanish. Full-Text PDF Open Archive