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Self‐Reported Heart Attack in Mexican‐American Elders: Examination of Incidence, Prevalence, and 7‐Year Mortality
Author(s) -
Otiniano Max E.,
Ottenbacher Kenneth J.,
Markides Kyriakos S.,
Ray Laura A.,
Du Xianglin L.
Publication year - 2003
Publication title -
journal of the american geriatrics society
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.992
H-Index - 232
eISSN - 1532-5415
pISSN - 0002-8614
DOI - 10.1046/j.1365-2389.2003.51304.x
Subject(s) - medicine , marital status , epidemiology , incidence (geometry) , diabetes mellitus , stroke (engine) , activities of daily living , odds ratio , demography , depression (economics) , gerontology , population , confidence interval , physical therapy , environmental health , optics , economics , macroeconomics , mechanical engineering , physics , engineering , sociology , endocrinology
OBJECTIVES: To examine the prevalence, incidence, and mortality of self‐reported heart attack in older Mexican Americans and to identify significant factors associated with heart attack. DESIGN: Cross‐sectional and longitudinal study. SETTING: Baseline and three follow‐up interviews in five southwestern states (Arizona, California, Colorado, New Mexico, and Texas) of the Hispanic Established Population for the Epidemiological Study of the Elderly. PARTICIPANTS: Three thousand fifty Mexican Americans aged 65 to 107 (mean age = 73). MEASUREMENTS: Sociodemographic factors (age, sex, marital status, language of interview, health insurance coverage, living arrangements, and financial strain) and health factors (smoking, alcohol consumption, obesity, diabetes mellitus, hypertension, stroke, cancer, hip fracture, arthritis, depression, limitations in activities of daily living (ADLs) and instrumental activities of daily living (IADLs), and mortality) were determined at baseline (1993–94). New heart attacks were assessed at follow‐ups in 1995–96, 1998–99, and 2000–01. Vital status was determined over the 7‐year follow‐up. RESULTS: Prevalence of self‐reported heart attack was 9.1% at baseline. Incidence of self‐reported heart attack was 6.1%, 9.1%, and 7.9%, respectively, for the three subsequent follow‐ups. Older age, male sex, diabetes mellitus, hypertension, and stroke were significantly associated with heart attack at baseline. Age was a significant predictor for new heart attack at each follow‐up. Having ADL (odds ratio (OR) = 2.91, 95% confidence interval (CI) = 2.19–3.86) and IADL (OR = 2.25, CI = 1.72–2.94) disabilities was significantly associated with self‐reported heart attack. Subjects with heart attack were significantly more likely to die at 7 years (hazard ratio = 1.57, 95% CI = 1.29–1.91). Of those with self‐reported heart attack, 42.4% had died of heart attack as the underlying cause of death by 7‐year follow‐up. CONCLUSION: In Mexican Americans, self‐reported heart attack was associated with being older and male and having diabetes mellitus, hypertension, stroke, and ADL and IADL disabilities. Nearly half of subjects with heart attack had died of heart attack as underlying cause of death by 7‐year follow‐up. Prevention and control for this disease would be especially important in this population to avoid early mortality.