Heart disease now leads deaths among Hispanic adults in the US

Clinical takeaway: Screen aggressively for obesity, diabetes, hypertension, dyslipidemia, and sleep problems in Hispanic adults, who often develop cardiovascular risk factors and cardiovascular disease at younger ages; prioritize culturally and linguistically appropriate care to improve treatment adherence and risk-factor control.

Cardiovascular disease (CVD) has surpassed cancer as the leading cause of death among Hispanic adults in the US, according to a new American Heart Association (AHA) scientific statement published in Circulation. The statement updates AHA's 2014 advisory and emphasizes that Hispanic populations are highly diverse, with important differences in cardiovascular risk across heritage groups, nativity, and social circumstances.

The statement reports that nearly 46% of Hispanic adults have obesity, 15.5% have type 2 diabetes, and about 44% have hypertension. Diabetes prevalence is nearly double that of non-Hispanic White adults, while awareness, treatment, and control of hypertension and dyslipidemia remain lower.

Cardiovascular events also occur earlier. Hispanic adults are diagnosed with heart failure approximately 8 to 9 years younger than White adults and experience a first stroke roughly 6 to 8 years earlier. Only about 1 in 5 Hispanic adults achieve ideal cardiovascular health metrics.

Although the document does not make treatment recommendations, it highlights important treatment gaps. Hispanic adults are less likely to receive lipid-lowering therapy, have lower statin adherence, and experience underuse of guideline-directed therapies for coronary disease, heart failure, and peripheral artery disease.

The statement urges clinicians to address language concordance, health literacy, insurance status, food insecurity, and other social factors that can affect medication adherence and long-term disease control. Community health worker programs, bilingual education, and partnerships with trusted community organizations are highlighted as promising strategies.

"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 writing committee chair Johanna Contreras, MD, MSc. "Without better representation and more detailed data, we risk overlooking important differences that can help us improve care and save lives."

What's changed

• CVD is now the leading cause of death among Hispanic adults, replacing cancer.
• The statement challenges the traditional "Hispanic paradox," noting that previously observed mortality advantages may be eroding because of rising obesity, diabetes, hypertension, and other cardiometabolic risks, particularly among U.S.-born Hispanic individuals.
• New evidence highlights substantial heterogeneity among Hispanic heritage groups, underscoring the limitations of treating Hispanic adults as a single population.
• Greater emphasis is placed on social and structural determinants of health, including insurance coverage, language barriers, food insecurity, environmental exposures, and immigration-related challenges.

Source: Contreras J, et al. (2026 Sep 15) Circulation. State of Cardiovascular Disease and Stroke in Hispanic/Latino Adults in the United States: A Scientific Statement From the American Heart Association