Hertz Robin P, Unger Alan N, Ferrario Carlos M
US Outcomes Research-Population Studies, Pfizer Global Pharmaceuticals, New York, New York, USA.
Am J Prev Med. 2006 Feb;30(2):103-10. doi: 10.1016/j.amepre.2005.10.015.
Ethnic disparities in healthcare quality have been documented, but knowledge of differences in cardiovascular risk factor prevalence, awareness, treatment, and control between Mexican Americans and non-Hispanic whites remains incomplete.
Cross-sectional analysis in 2005 of nationally representative data collected from 2256 Mexican-American and 4624 non-Hispanic white adults aged 20 years and over who participated in the 1999-2002 National Health and Nutrition Examination Survey.
Type 2 diabetes is significantly more prevalent in Mexican Americans (13% age and gender adjusted) than in non-Hispanic whites (8%); however, Mexican Americans are more likely to be both diagnosed (77% vs 65%) and treated (63% vs 47%). There is no significant difference in the adjusted prevalence of hypertension, at 28% for non-Hispanic whites compared to 26% for Mexican Americans. Mexican Americans have a slightly lower adjusted prevalence of dyslipidemia, at 31% versus 35%. Awareness of hypertension and dyslipidemia are significantly lower in Mexican Americans (57% vs 71% for hypertension, and 33% vs 56% for dyslipidemia). Treatment rates for hypertension and dyslipidemia are also significantly lower in Mexican Americans (42% vs 61% for hypertension; 14% vs 30% for dyslipidemia). Multivariate logistic regression controlling for age, gender, education, and access to care indicate that Mexican Americans are significantly more likely than non-Hispanic whites to be aware and treated for their diabetes, but significantly less likely to be aware and treated for their hypertension or dyslipidemia.
The significantly higher prevalence of diabetes in Mexican Americans, in contrast to hypertension and dyslipidemia, may sensitize healthcare providers to its detection and treatment. Communicating the importance of hypertension and dyslipidemia is essential for eliminating disparities.
医疗质量方面的种族差异已有记录，但墨西哥裔美国人与非西班牙裔白人在心血管危险因素患病率、知晓率、治疗和控制方面的差异仍不完全清楚。
对2005年从2256名年龄在20岁及以上的墨西哥裔美国成年人和4624名非西班牙裔白人成年人收集的具有全国代表性的数据进行横断面分析，这些人参加了1999 - 2002年全国健康和营养检查调查。
2型糖尿病在墨西哥裔美国人中的患病率（年龄和性别调整后为13%）显著高于非西班牙裔白人（8%）；然而，墨西哥裔美国人更有可能被诊断（77%对65%）和接受治疗（63%对47%）。非西班牙裔白人高血压调整患病率为28%，墨西哥裔美国人为26%，两者无显著差异。墨西哥裔美国人血脂异常调整患病率略低，为31%，而非西班牙裔白人为35%。墨西哥裔美国人对高血压和血脂异常的知晓率显著较低（高血压为57%对71%，血脂异常为33%对56%）。墨西哥裔美国人高血压和血脂异常的治疗率也显著较低（高血压为42%对61%；血脂异常为14%对30%）。控制年龄、性别、教育程度和医疗可及性的多变量逻辑回归表明，墨西哥裔美国人比非西班牙裔白人更有可能知晓并治疗其糖尿病，但知晓并治疗其高血压或血脂异常的可能性显著较低。
与高血压和血脂异常相比，墨西哥裔美国人中糖尿病患病率显著更高，这可能使医疗服务提供者对其检测和治疗更加敏感。宣传高血压和血脂异常的重要性对于消除差异至关重要。
