The Hispanic Paradox and Lifestyle Factors
There is a unique epidemiological phenomenon called the Hispanic paradox, which states that Hispanics in the United States have a lower rate of CVD mortality and a longer life expectancy relative to non-Hispanic White counterparts despite a higher prevalence of CVD risk factors and disadvantageous socioeconomic conditions.32 This observation could guide further research on potential cardioprotective factors in Hispanic populations that could be extrapolated to other ethnicities. A systematic review and meta-analysis conducted by Ruiz et al. illustrated this paradox by examining 58 studies that reported on Hispanic all-cause mortality compared to those from other ethnicities.6 Overall, Hispanic populations had an overall lower risk of mortality compared to non-Hispanic White demographics and non-Hispanic Black demographics, and this variation was especially pronounced in the context of CVD. Another study by Mossavar-Rahmani et al. examined the prospective link between physical activity, sedentary behavior, and cardiometabolic biomarkers in a cohort of 8,049 United States Hispanics/Latinos.33They revealed that low sedentary behavior and adherence to physical activity guidelines are linked to health benefits, especially in normoglycemic adults without CVD. This could further provide evidence for this paradoxical observation.33 Lifestyle modifications could have a more cardioprotective effect on the mortality associated with ion channelopathies than previously hypothesized. The accumulation of these studies has built a broad base of knowledge on ion channelopathies and the prevalence of arrhythmias in Hispanic/Latino populations. Nonetheless, further studies should be conducted within families and various ethnic subgroups to determine significant genetic and environmental factors affecting the development of cardiac ion channelopathies in these populations.