The Latin Way

By Dr. Juan Rivera

As a cardiovascular prevention specialist, I am constantly searching for ways to improve my patients' health education, lifestyle and quality of life. My job transcends the clinical realm though. As Univision's Chief Medical Correspondent, I have the responsibility, as I see it, to use my media platform to literally improve the health outcome of the Latino community. I spend countless hours thinking about developing and delivering culturally sensitive content for my audience. Learning about which TV segments stick and make a difference versus those which don't is a personal obsession of mine. It is the holy grail of effective communication and it gets to the core of human behavior.

The answer unexpectedly came to me during a routine clinical office visit. A Latin couple, in their 50s, was sitting in front of me. It was immediately obvious that the husband was not there voluntarily. The only words coming out of his mouth were: "Doctor, I don't know what I am doing here. I am fine". The woman, a well-dressed, talkative, decisive Cubana, immediately took charge. "You are here because your father and your brother died of heart disease. You are not dying on me... and you will do what I'll tell you to do." My initial thought was "Damn, you go girl!" But I was immediately intimidated as well. And that was my eureka moment... any Hispanic man, no matter how "macho man" he thinks he is, cannot fight the amazing strength and will of a Latina.

Latinas are the north star of our community and the hope for healthier generations. They organize our lives, take care of us when we fall ill, and represent the will power that keeps our families thriving and moving forward. In the case of the above mentioned couple, after a detailed work up, I discovered that the man had severe atherosclerosis and was in need of significant lifestyle changes as well as medication to prevent a fatal event. To this date, I believe that she saved his life. He never misses an appointment.

If we want to have a chance to improve cardiovascular outcomes in the Latino community, we have to center our efforts on the heads of the families, Latinas. That being said, it is also important to understand that they will take care of everyone around them before attending to their own needs. As a man married to one, I have experienced their amazing altruism. But for the benefit of our community, that has to change.

Latinas need to understand that approximately 43 million women in the United States suffer from cardiovascular disease, as stated by the American Heart Association's Go Red For Women movement. Since 1984, more women than men have died of heart disease each year. Only 44 percent of Latinas know that heart disease represents the number one cause of death for them. Unfortunately, their symptoms are often dismissed by health care professionals in part due to a horrible stigma that Latinas, and women in general, are more "hysterical", "unable to handle stress" or more "expressive" -- a term used to imply that they exaggerate their symptoms. Heart attacks are also often misdiagnosed because the symptoms tend to be atypical. While most people think that a crushing, pressure-like, left-sided chest pain is the hallmark of a myocardial event, women can present with fatigue, right arm pain, shortness of breath, or a burning chest pain.

Latinas can make a difference for themselves and their families. Here is how:

1. Schedule a yearly Cardiovascular Prevention work up for you and your husband. It is important to check for blood sugar (diabetes is very prevalent in our community), high blood pressure, high cholesterol and obesity indicators. Ask your doctor about tests to detect occult plaque in your coronary and carotid arteries. And most importantly, do not ignore your symptoms!

2. Make cooking a healthy family experience. Insist that your husband and kids get involved as opposed to allowing them to watch TV or play video games while you do all the work. Introduce new vegetables, healthier whole grain carbohydrates and good fats into the meals. Talk about the importance of a healthy diet to prevent disease and for the kids' physical and mental development.

3. Get your family off of the couch! Involve them in regular physical activity.

4. Be the sleep custodian of the house. Sleeping less than seven hours a day is associated with increased mortality, obesity and cardiovascular risk.

5. Smile and stay positive! You have a way of smiling and celebrating life that is contagious. Happiness is one of the best preventive therapies!

You can also visit or to learn other tips to reduce your risks of heart disease -- and be sure to tell every woman in your life. Wear your RED on National Wear Red Day, Friday, Feb. 6, as a symbol of spreading awareness about heart disease among Latinas.

I want to see cardiovascular events decreasing in the Hispanic population. Let's empower Latinas with the resources that they need to take better care of themselves and their families. Let's advocate for more accessible health education, more access to health services and to eliminate job discrimination. Let's stand for equal pay, affordable healthy food, safe neighborhoods... let's advocate for the respect and credit that they deserve. Latinas are unarguably the CEOs of our households; they can create change. This is the Latin way.


Juan J. Rivera M.D., M.H.S. is the Director of Cardiovascular Prevention Mount Sinai Hospital, Miami Beach, FL. and Univision's Chief Medical Correspondent.