Cardiovascular disease has overtaken cancer as the leading cause of death among Hispanic adults in the United States, according to a scientific statement from the American Heart Association published Tuesday in the journal Circulation.
The statement finds that heart and stroke problems often appear earlier in Hispanic adults. On average, Hispanic adults are diagnosed with heart failure about 8 to 9 years younger than white adults and have a first stroke about 6 to 8 years younger, at about age 67 compared with 73 to 75.
That shift puts pressure on working-age adults, not only on older relatives. Hispanic people make up nearly 1 in 5 U.S. residents and are the nation's largest ethnic minority group.
Risk Factors Arriving Years Earlier
The AHA writing group reported that nearly 46% of Hispanic adults have obesity, with the highest rates among people of Puerto Rican and Dominican heritage. Type 2 diabetes affects 15.5% of Hispanic adults, nearly twice the rate among white adults, and is most common among people of Mexican and Puerto Rican heritage. About 44% have high blood pressure, yet awareness, treatment, and control rates remain lower than among white adults.
Only about 1 in 5 Hispanic adults meets the AHA's original definition of ideal cardiovascular health, known as Life's Simple 7. Fewer than 2% meet sodium goals, and nearly one-third report no moderate-to-vigorous leisure-time physical activity, the highest share of any U.S. racial or ethnic group. About one-third sleep less than seven hours a night.
U.S.-born Hispanic adults have shorter life expectancy and higher death rates than those born in other countries, driven by heart disease, stroke, and multiple risk factors, the statement found. Higher intake of ultra-processed foods and sugar-sweetened drinks was more common among U.S.-born adults.
"Hispanic populations in the U.S. are incredibly diverse even within their own communities with differences in genetic ancestry, language, cultural traditions and social experiences that can significantly influence cardiovascular health," said Dr. Johanna Contreras, who chaired the writing group and directs the Division of Heart Failure within the Mount Sinai Health System in New York. She said more detailed data across heritage groups "will be essential to better understand community-specific risks, strengths and healthcare needs."
Barriers Beyond the Clinic
The writing group stressed that biology alone does not explain the gap. About 20% of Hispanic adults were uninsured in 2023, compared with 6.4% of white adults. About 17% of Hispanic people live below the federal poverty threshold, compared with 8.2% of white adults. About 41% of Hispanic adults, including 66% of older Hispanic adults, have low or limited health literacy.
"Limited health insurance coverage, language differences, food insecurity, environmental exposures and concerns related to immigration status can make it more difficult to prevent disease, manage chronic conditions and receive timely treatment," Contreras said.
Earlier research points to the same pattern. A 2018 study summarized by American Heart Association News found that Hispanic adults living in counties with high concentrations of Hispanic residents were about 60% more likely to die from heart disease and stroke than those who did not. Those counties had higher poverty, more uninsured residents, and fewer primary care doctors.
The new statement calls for greater use of community health workers, bilingual health education, and partnerships with trusted community settings to make prevention easier to reach.
The findings also add to questions about the so-called Hispanic paradox, the idea that Hispanic adults die of cardiovascular disease at lower rates despite higher risk factors. An analysis led by Dr. Erin Michos of Johns Hopkins, published in 2022, found lower overall cardiovascular death rates among Hispanic adults. However, it also found faster-rising heart failure death rates among Hispanic adults younger than 65 and rising stroke death rates among Hispanic men and older adults. "Our data do not support the Hispanic paradox," Michos said at the time. She was not part of the new statement.
A scientific statement reviews existing research and highlights gaps, but it does not issue treatment recommendations. Much of the underlying evidence is observational and cannot show that any single factor causes the differences. The authors also note that Hispanic people remain underrepresented in cardiovascular research.
Protecting Your Heart and Your Family's
Adults can start by knowing their numbers. Ask a clinician or pharmacist to check blood pressure, blood sugar, and cholesterol, and ask whether earlier or more frequent screening makes sense if diabetes or heart disease runs in the family. The AHA's Life's Essential 8 framework covers diet, physical activity, sleep, nicotine exposure, weight, cholesterol, blood sugar, and blood pressure.
Family members often help translate medical information, Contreras noted. Many hospitals and clinics offer free language assistance, so patients can ask for a professional medical interpreter to avoid misunderstandings about medications or test results.
Because risk factors appear at younger ages, family habits matter early. Meals with less sodium, fewer sugary drinks, and more regular activity can benefit children as well as adults.
For people without insurance, community health centers offer sliding-scale fees, and many pharmacies and health fairs provide free blood pressure checks. Anyone taking blood pressure or diabetes medicine should not stop without talking to a clinician.
Know the emergency signs and act fast. Chest pain or pressure, shortness of breath, sudden face drooping, arm weakness, or slurred speech requires an immediate 911 call. The AHA lists heart attack and stroke warning signs on its website.
The AHA is calling for culturally tailored prevention through churches, markets, community centers, and Spanish-language media, along with more detailed research by heritage groups. MedicalDaily will follow whether health systems and policymakers act on those recommendations.
Key Questions Answered
What did the American Heart Association report? That cardiovascular disease has surpassed cancer as the leading cause of death among Hispanic adults in the U.S.
How much earlier do heart problems appear? On average, Hispanic adults are diagnosed with heart failure about 8 to 9 years earlier and have a first stroke about 6 to 8 years earlier than white adults.
What risk factors are most common? Obesity, type 2 diabetes, and high blood pressure, along with low physical activity and short sleep.
Does the statement change treatment guidelines? No. Scientific statements summarize evidence and do not issue treatment recommendations.
Who is most affected? Risks vary by heritage group. U.S.-born Hispanic adults have shorter life expectancy and higher death rates than those born in other countries.
What can people do now? Check blood pressure, blood sugar, and cholesterol, share family history with a clinician, and seek care early.
What are stroke warning signs? Face drooping, arm weakness, and speech difficulty. Call 911 immediately.
