The American Heart Association’s new scientific statement reveals that heart disease has surpassed cancer as the leading cause of death among Hispanic adults in the U.S. The finding, based on 2022 data, applies to a population of roughly 68 million people—a diverse group whose risks vary by heritage, birthplace, and social conditions.
The analysis, published in Circulation on September 15, 2026, challenges the long-held “Hispanic paradox,” which suggested that this group historically experienced lower heart disease death rates despite higher obesity and diabetes prevalence. The statement clarifies that the paradox does not apply uniformly across subgroups. For instance, Puerto Rican and Dominican adults now exhibit obesity rates of 46%, while Mexican and Puerto Rican adults lead in type 2 diabetes prevalence at 15.5%, nearly double that of non-Hispanic white adults. Undiagnosed cases further complicate the picture.
High blood pressure affects 44% of Hispanic adults, matching rates among white adults, but control remains difficult to achieve. Among those with diabetes in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), only 43% met blood sugar targets, 49% controlled blood pressure, and 37% managed LDL cholesterol. Just 8.4% met all three measures. Heritage-specific disparities also emerge: Cuban adults have the highest LDL cholesterol levels, while Dominican adults show the highest triglyceride levels. For women, 71% carry at least one risk factor, with Puerto Rican women facing the greatest burden.
Heart disease strikes Hispanic adults earlier than other groups. They develop heart failure eight to nine years sooner than white adults, and their average stroke onset age is 67, compared with 73 to 75 for white adults. Life expectancy gaps persist, with U.S.-born Hispanic adults living shorter lives and facing higher death rates than those born abroad. On the AHA’s Life’s Essential 8 heart health score, Hispanic adults consistently perform worse.
Systemic barriers deepen heart disease risks
Systemic barriers contribute significantly to these disparities. Nearly one in five Hispanic adults lacked insurance in 2023, compared with 6.4% of white adults. Fear of immigration enforcement deters some from seeking preventive care or managing chronic conditions. Even when insured, language barriers, limited access to healthy food, and uneven specialist distribution create obstacles. Cholesterol-lowering drugs and advanced heart failure therapies are prescribed less often to Hispanic patients, according to the statement.
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Community health workers and food programs, such as medically tailored groceries and produce prescriptions, offer partial solutions. However, Johanna Contreras, M.D., M.Sc., director of heart failure research at the AHA, emphasizes that awareness alone will not address the gap. “Awareness without access is not enough,” she stated in an AHA news release.
The findings stem from national surveys and long-running studies, including HCHS/SOL data collected as early as 2008. Yet gaps persist. Many datasets still aggregate Hispanic adults without distinguishing between Mexican, Puerto Rican, Cuban, and Dominican populations. Underrepresentation in clinical trials and genetic studies limits tailored treatments, while risk calculators have been tested less in Hispanic populations, leaving prediction and prevention gaps.
Data gaps and tailored solutions needed
The authors advocate for disaggregated data by heritage and integration of social determinants, such as income, immigration status, and language, into risk assessments. Culturally tailored care, more bilingual clinicians, and safeguards against bias in AI tools are also critical. These steps align with the AHA’s 2028 Impact Goals, which aim to reduce heart disease disparities across all communities.
Genetic research remains a critical gap. While studies have identified genetic variants linked to heart disease in white populations, fewer have focused on Hispanic groups. The AHA’s review highlights emerging evidence that certain heritage-specific genetic markers, such as those tied to diabetes in Mexican and Puerto Rican adults, may influence heart disease risk differently. Underrepresentation in genomic databases means these insights are rarely applied clinically. The statement urges expanded genetic studies with diverse Hispanic cohorts, emphasizing that personalized medicine cannot advance without this foundational work.
