Community-wide coronary heart disease mortality in Mexican Americans equals or exceeds that in non-Hispanic whites: The Corpus Christi Heart Project

PURPOSE: Previous comparisons of coronary heart disease mortality between M exican Americans and non-Hispanic whites have given paradoxic results: desp ite their adverse cardiovascular risk profiles, especially a greater preval ence of diabetes, Mexican Americans are reported to have lower rates of mor tality from coronary heart disease. SUBJECTS AND METHODS: We performed a community-based surveillance among all residents of Nueces County, Texas, aged 25 to 74 years, from 1990 to 1994. All death certificates were obtained and coded, and deaths potentially rel ated to coronary heart disease were selected and validated by standardized methods blinded to ethnicity. Validated in-hospital and out-of-hospital cor onary heart disease mortality was compared between 785 Mexican Americans an d 862 non-Hispanic white women and men. RESULTS: Validated coronary heart disease mortality in Mexican Americans ex ceeded that for non-Hispanic whites in the same community. Among women, def inite coronary heart disease mortality was 40% greater among Mexican Americ ans irate ratio [RR] 1.43, 95% confidence interval [CII: 1.12 to 1.82), as was all coronary heart disease mortality (RR, 1.32, 95% CI: 1.08 to 1.63). Among men, Mexican Americans had greater rates of all (RR, 1.1 1;95% CI: 0. 96 to 1.28) and definite coronary heart disease mortality (RR, 1.16; 95% CI : 0.91 to 1.47), but the associations were not statistically significant. CONCLUSIONS: When community-wide mortality rates from coronary heart diseas e are properly validated, Mexican Americans have rates equal to or higher t han those of non-Hispanic whites. Community-based surveillance with validat ion of coronary heart disease as the cause of death is necessary to avoid t he errors that occur with the use of death certificates alone. (C) 2001 by Excerpta Medica, inc.