Mitchell B D, Hazuda H P, Haffner S M, Patterson J K, Stern M P
Department of Medicine, University of Texas Health Science Center at San Antonio 78284-7873.
Ann Epidemiol. 1991 Aug;1(5):415-26. doi: 10.1016/1047-2797(91)90011-z.
Mexican-American men experience lower rates of cardiovascular mortality and have a lower prevalence of nonfatal myocardial infarction than do non-Hispanic white men. To see if this ethnic difference exists for other cardiovascular end points, we compared the prevalence of angina pectoris, as assessed by the Rose Angina Questionnaire, between Mexican Americans (n = 3272) and non-Hispanic whites (n = 1848) examined in the San Antonio Heart Study, a population-based survey of cardiovascular disease and diabetes conducted in San Antonio, Texas, between 1979 and 1988. Contrary to our expectations, angina prevalence was approximately twice as high in Mexican Americans as in non-Hispanic whites, with age-adjusted odds ratios of 2.01 (95% confidence interval (CI), 1.13 to 3.58; P = .02) in men and 1.84 (95% CI, 1.26 to 2.70; P = .001) in women. After controlling for age, body mass index, diabetes status, cigarette smoking, and educational level by logistic regression analysis, angina prevalence remained statistically associated with Mexican American ethnicity in men, but not women. There was little ethnic difference in the proportion of Mexican-American and non-Hispanic white subjects who reported nonspecific chest pain (chest pain not meeting the Rose criteria), suggesting that the ethnic difference in angina prevalence was not an artifact of reporting bias. This was further supported by the fact that the conventional cardiovascular risk factors were more strongly associated with angina prevalence in Mexican Americans than in non-Hispanic whites. These data suggest that Mexican-American men experience high rates of angina despite low rates of myocardial infarction. Future studies should investigate ethnic factors that may have differential effects on the various manifestations of coronary heart disease.
与非西班牙裔白人男性相比，墨西哥裔美国男性的心血管疾病死亡率较低，非致命性心肌梗死的患病率也较低。为了探究这种种族差异在其他心血管疾病终点是否存在，我们比较了在圣安东尼奥心脏研究中接受检查的墨西哥裔美国人（n = 3272）和非西班牙裔白人（n = 1848）心绞痛的患病率。该研究是1979年至1988年在得克萨斯州圣安东尼奥市进行的一项基于人群的心血管疾病和糖尿病调查。与我们的预期相反，墨西哥裔美国人的心绞痛患病率大约是非西班牙裔白人的两倍，男性年龄调整后的优势比为2.01（95%置信区间[CI]，1.13至3.58；P = .02），女性为1.84（95%CI，1.26至2.70；P = .001）。通过逻辑回归分析控制年龄、体重指数、糖尿病状态、吸烟和教育水平后，男性心绞痛患病率与墨西哥裔美国种族仍存在统计学关联，而女性则不然。报告非特异性胸痛（不符合罗斯标准的胸痛）的墨西哥裔美国人和非西班牙裔白人受试者比例几乎没有种族差异，这表明心绞痛患病率的种族差异不是报告偏倚造成的假象。传统心血管危险因素与墨西哥裔美国人心绞痛患病率的关联比非西班牙裔白人更强，这一事实进一步支持了上述观点。这些数据表明，尽管墨西哥裔美国男性心肌梗死患病率较低，但心绞痛患病率较高。未来的研究应调查可能对冠心病各种表现有不同影响的种族因素。
