LaRosa John C, Brown Clinton D
Office of the President, SUNY Downstate Medical Center, Brooklyn, NY 11203-2098, USA.
Am J Med. 2005 Dec;118(12):1314-22. doi: 10.1016/j.amjmed.2005.04.041.
Recent clinical trials have confirmed the value of intervention on major risk factors, particularly hypertension and hyperlipidemia, in preventing the progression and clinical sequelae of atherosclerosis. Less is known about the prevalence and impact of atherosclerosis risk factors in minorities. A review of recent literature reporting the prevalence of established and new predictors of atherosclerotic events in minority populations and the inclusion of minorities in clinical trials is presented. The prevalence of risk factors differs considerably in minority populations. The role of "premature" coronary death and the level of some risk factors, particularly obesity and blood pressure in African descendants and high triglycerides, low high-density lipoproteins, and diabetes in some Hispanics, is higher than in whites. With few exceptions, however, minorities have not been included in clinical trials in sufficient numbers to determine whether significant differences in the benefit of risk factor intervention exists. Prevalence of key risk factors differs among minority groups. Risk factor intervention should be pursued in minority groups but with the understanding that clinical trials have not ruled out the possibility of qualitative or quantitative differences in response rates among different groups.
近期的临床试验已证实，干预主要危险因素，尤其是高血压和高脂血症，对于预防动脉粥样硬化的进展和临床后遗症具有重要价值。关于动脉粥样硬化危险因素在少数族裔中的患病率及影响，人们了解得较少。本文综述了近期文献，这些文献报告了少数族裔人群中已确定的和新的动脉粥样硬化事件预测因素的患病率，以及少数族裔在临床试验中的纳入情况。危险因素的患病率在少数族裔人群中差异很大。“过早”冠心病死亡以及某些危险因素的水平，尤其是非洲裔后代中的肥胖和血压，以及一些西班牙裔中的高甘油三酯、低高密度脂蛋白和糖尿病，其发生率高于白人。然而，除了少数例外情况，少数族裔在临床试验中的纳入数量不足以确定危险因素干预的益处是否存在显著差异。关键危险因素的患病率在少数族裔群体中各不相同。应在少数族裔群体中开展危险因素干预，但要明白临床试验并未排除不同群体之间反应率在定性或定量方面存在差异的可能性。
