Prevalence and Risk Factors in Hispanic/Latino Populations
There have been efforts to characterize the global prevalence and
clinical risk factors of cardiovascular disease (CVD) and arrhythmias in
Hispanic/Latino populations (Figure 1 ). A study by Linares et
al. determined the weighted prevalence of atrial fibrillation (AF) in a
representative Hispanic/Latino population (n=16,415) to be 1%, with the
highest prevalence in Dominicans (1.9%) and Puerto Ricans (2.5%) and
the lowest prevalence in Mexicans (0.3%).14 Factors
associated with higher AF prevalence included diabetes, hypertension,
renal disease, left ventricular hypertrophy, and alcohol
use.15 Interestingly, the association with renal
disease is similar to the finding from the PRESTO, HCHS/SOL study
conducted by Reinier et al. in Ventura Country,
California.16, 17 A retrospective study by Shulman et
al. compared the predictive power of PR interval in the development of
AF in non-Hispanic White, Hispanic, and AA/Black
populations.18 The group discovered that at a PR
interval of 196-201ms, there was a significant association among all
ethnic groups in the study. However, there was no significant
association at PR intervals far above 200ms.18 In a
study comparing autopsy-defined causes of SCD by Tseng et al., Hispanic
subjects, along with Asian subjects, had a lower rate of developing SCD
due to a fatal arrhythmia compared to White
subjects.19 Of note, there was a higher incidence of
Hispanic subjects who developed primary electrical disease compared to
the reference White cohort.19
In a recent cross-sectional observational study by Manini et al., the
authors prospectively enrolled adult patients presenting to the
emergency department with acute drug overdose secondary to prescription
medications and illicit substances over a two-year
period.20 A noteworthy discovery from this analysis is
the observation that individuals of Hispanic descent demonstrated a
relative resistance to drug-induced QT prolongation in cases of
overdose. This finding is of particular significance as it highlights a
distinctive characteristic within the Hispanic population that renders
them less susceptible to the prolongation of QT intervals caused by drug
overdose. This resistance to drug-induced QT prolongation in Hispanic
populations may have implications for both clinical practice as well as
further research endeavors. Understanding this inherent resistance could
potentially influence medical decision-making, treatment strategies, and
dosage adjustments in the management of drug overdoses, particularly in
Hispanic patients. Delving deeper into the molecular and genetic aspects
of this resistance may unravel novel insights into the mechanisms
underlying QT interval regulation, thus providing a foundation for
future investigations and the development of targeted therapeutic
interventions.21 These results suggest that
race-specific factors may influence electrocardiogram (ECG) outcomes.
Therefore, a detailed exploration of these factors is essential for a
more accurate and inclusive interpretation of SCD and cardiac health
assessments in general.