Prevalence and Risk Factors in Hispanic/Latino Populations
There have been efforts to characterize the global prevalence and clinical risk factors of cardiovascular disease (CVD) and arrhythmias in Hispanic/Latino populations (Figure 1 ). A study by Linares et al. determined the weighted prevalence of atrial fibrillation (AF) in a representative Hispanic/Latino population (n=16,415) to be 1%, with the highest prevalence in Dominicans (1.9%) and Puerto Ricans (2.5%) and the lowest prevalence in Mexicans (0.3%).14 Factors associated with higher AF prevalence included diabetes, hypertension, renal disease, left ventricular hypertrophy, and alcohol use.15 Interestingly, the association with renal disease is similar to the finding from the PRESTO, HCHS/SOL study conducted by Reinier et al. in Ventura Country, California.16, 17 A retrospective study by Shulman et al. compared the predictive power of PR interval in the development of AF in non-Hispanic White, Hispanic, and AA/Black populations.18 The group discovered that at a PR interval of 196-201ms, there was a significant association among all ethnic groups in the study. However, there was no significant association at PR intervals far above 200ms.18 In a study comparing autopsy-defined causes of SCD by Tseng et al., Hispanic subjects, along with Asian subjects, had a lower rate of developing SCD due to a fatal arrhythmia compared to White subjects.19 Of note, there was a higher incidence of Hispanic subjects who developed primary electrical disease compared to the reference White cohort.19
In a recent cross-sectional observational study by Manini et al., the authors prospectively enrolled adult patients presenting to the emergency department with acute drug overdose secondary to prescription medications and illicit substances over a two-year period.20 A noteworthy discovery from this analysis is the observation that individuals of Hispanic descent demonstrated a relative resistance to drug-induced QT prolongation in cases of overdose. This finding is of particular significance as it highlights a distinctive characteristic within the Hispanic population that renders them less susceptible to the prolongation of QT intervals caused by drug overdose. This resistance to drug-induced QT prolongation in Hispanic populations may have implications for both clinical practice as well as further research endeavors. Understanding this inherent resistance could potentially influence medical decision-making, treatment strategies, and dosage adjustments in the management of drug overdoses, particularly in Hispanic patients. Delving deeper into the molecular and genetic aspects of this resistance may unravel novel insights into the mechanisms underlying QT interval regulation, thus providing a foundation for future investigations and the development of targeted therapeutic interventions.21 These results suggest that race-specific factors may influence electrocardiogram (ECG) outcomes. Therefore, a detailed exploration of these factors is essential for a more accurate and inclusive interpretation of SCD and cardiac health assessments in general.