Sekikawa A, Kuller L H
Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania 15213, USA.
J Womens Health Gend Based Med. 2000 Jun;9(5):545-58. doi: 10.1089/15246090050073639.
Coronary heart disease (CHD) is the leading cause of death for women in the United States. There has been a substantial decrease in CHD mortality in the past few decades in the United States for both women and men. The change in lifestyle after World War II may affect the incidence of and mortality from CHD in a more recent birth cohort, such as the 45-54-year-old age group. CHD mortality among women aged 45-54 by state and race in the United States and other countries in 1994 was evaluated. Correlation of the CHD mortality with state-specific and race-specific educational attainment (% of not a high school graduate) and state-specific prevalence of smoking was examined. There was a 2.5-fold difference in CHD mortality (ICD 410-414, 429.2) between black and white women aged 45-54: 78/100,000 for black versus 31/100,000 for white women; a 3-fold difference in CHD mortality among white women by state: 16/100,000 in Colorado versus 53/100,000 in Louisiana; and a 3-fold difference in CHD mortality among black women by state: 45/100,000 in New Jersey versus 124/100,000 in Arkansas. CHD mortality was correlated with educational attainment among white women (r = 0.62, p = 0.001) and with prevalence of smoking (r = 0.39, p = 0.021). There is a large variation in CHD mortality among women aged 45-54 in the United States by race and state. These differences may reflect variations in coronary risk factors. More detailed evaluation of determinants of CHD mortality by area is needed, as are public health programs that can reduce the marked disparity in CHD mortality in the United States.
冠心病(CHD)是美国女性的主要死因。在过去几十年里,美国男性和女性的冠心病死亡率都有显著下降。二战后生活方式的改变可能会影响更近期出生队列(如45 - 54岁年龄组)中冠心病的发病率和死亡率。评估了1994年美国及其他国家45 - 54岁女性按州和种族划分的冠心病死亡率。研究了冠心病死亡率与各州特定和种族特定的教育程度(非高中毕业生的百分比)以及各州特定的吸烟率之间的相关性。45 - 54岁的黑人女性和白人女性之间的冠心病死亡率(国际疾病分类410 - 414、429.2)存在2.5倍的差异:黑人女性为78/10万,而白人女性为31/10万;按州划分,白人女性的冠心病死亡率存在3倍的差异:科罗拉多州为16/10万,而路易斯安那州为53/10万;按州划分,黑人女性的冠心病死亡率也存在3倍的差异:新泽西州为45/10万,而阿肯色州为124/10万。白人女性的冠心病死亡率与教育程度相关(r = 0.62,p = 0.001),与吸烟率相关(r = 0.39,p = 0.021)。在美国,45 - 54岁女性的冠心病死亡率因种族和州而存在很大差异。这些差异可能反映了冠状动脉危险因素的差异。需要对按地区划分的冠心病死亡率决定因素进行更详细的评估,也需要能够减少美国冠心病死亡率显著差距的公共卫生项目。