within NHLBI's Hispanic Community Health Study/ Study of Latinos
Dyslipidemia, defined as high total or LDL cholesterol, low HDL cholesterol, and/or high triglycerides is highly prevalent in US Hispanics (~65%) with significant variations seen by Hispanic heritage groups. LDL cholesterol is an important marker of cardiovascular risk and treatment to lower LDL prevents heart attacks and strokes. However, significant residual risk remains after reducing LDL and this may be attributable to nontraditional lipid markers such as apoB and Lp(a).
This is particularly relevant in the Hispanic population where there are higher prevalences of low HDL cholesterol and/or high triglycerides despite similar LDL levels compared to non-Hispanic Whites. This pattern of mixed dyslipidemia translates to a more potentially risky cholesterol pattern of small, dense LDL that is more likely to transfer from the plasma to the arterial wall than its larger, more buoyant counterpart. Cardiovascular
risk among Hispanics may be better accounted for by non-traditional lipid markers such as apoB and Lp(a). The inclusion of apoB and Lp(a) as risk enhancers in the 2018 AHA/ACC cholesterol guidelines raises the urgent question of their performance in US Hispanics.
This ancillary study will support the measurement of these unique risk markers and their associations with future heart disease and strokes in a diverse population of US Hispanics.
The NMC Alliance is conducting an ancillary study in order to better understand biomarkers specific to dyslipidemia in Hispanic/Latino sub-group populations.
About the HCHS/SOL Study
In 2014, the American Heart Association (AHA) released a scientific statement on the status of cardiovascular disease (CVD) and stroke in Hispanics/Latinos in the United States. In this statement, the scientific advisory board noted the fact that Hispanics are the largest minority ethnic group in the United States, yet data on the prevalence of risk factors for CVD among Hispanic subgroups is suboptimal.
Additionally, the authors stated that "an incomplete understanding of Hispanic populations in academic research has produced a lack of comprehensive data addressing Hispanic health and CVD, discordant literature regarding CVD risk factors and its prevalence, and a decreased understanding of health status and risk factors contributing to health disparities for US Hispanics."
The Hispanic Community Health Study (HCHS) / Study of Latinos (SOL) is a multi-center epidemiological study focused on Hispanic and Latino populations that began in 2006. The purpose of this is to understand the effects of acculturation disease prevalence and development, and to identify factors affecting the health of this specific population. Participants aged 18 to 74 years were divided based on origin of Cuban, Puerto Rican, Dominican, Mexican, and Central/South American.
The Hispanic Community Health Study / Study of Latinos is primarily sponsored by the National Heart, Lung, and Blood Institute (NHLBI) and six other centers and Institutes of the National Institutes of Health (NIH) have contributed to the ongoing work. The Make Well Foundation is pleased to partner with this project by providing funds for laboratory analysis of Lpa, personnel support, analytic support, logistical support.
Dr. Carlos Jose Rodriguez a HCHS/SOL investigator and Dr. Parag Joshi are the PIs of the study.