Yancy Clyde W, Strong Mark
University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, USA.
Congest Heart Fail. 2004 Jan-Feb;10(1):15-8; quiz 21-2. doi: 10.1111/j.1527-5299.2004.02026.x.
Heart failure is more common in African Americans and appears to be of worse severity. At the time of diagnosis, left ventricular function is more severely impaired and the clinical class is more advanced. The strongest risk factor for heart failure in African Americans appears to be hypertension, which is both more prevalent and more pathologic in African Americans. It is likely that heart failure represents an important end organ effect of hypertension. When affected by heart failure, African Americans experience a greater rate of hospitalization and may be exposed to a higher mortality risk as well. Genomic medicine has yielded a number of candidate single nucleotide polymorphisms that might contribute to the excess pathogenicity of heart failure in African Americans, but much more work needs to be done in larger cohorts. Effective therapy of heart failure must start with the recognition of the different manifestations of heart failure in African Americans. An increased awareness of the risk of hypertension followed by early and effective intervention may reduce the risk of heart failure in this population.
心力衰竭在非裔美国人中更为常见，而且似乎严重程度更高。在诊断时，左心室功能受损更严重，临床分级也更 advanced。非裔美国人发生心力衰竭的最强危险因素似乎是高血压，高血压在非裔美国人中既更普遍，也更具病理性。心力衰竭很可能是高血压的一种重要终末器官效应。非裔美国人患心力衰竭时，住院率更高，而且可能面临更高的死亡风险。基因组医学已经产生了一些可能导致非裔美国人心力衰竭致病性过高的候选单核苷酸多态性，但需要在更大的队列中开展更多工作。心力衰竭的有效治疗必须从认识到非裔美国人心力衰竭的不同表现开始。提高对高血压风险的认识，随后进行早期有效干预，可能会降低该人群发生心力衰竭的风险。
