Lowry P J, Lamb P, Watson R D, Ellis K E, Singh S P, Littler W A, Pentecost B L
General Hospital, Birmingham.
Br Heart J. 1991 Jul;66(1):29-35. doi: 10.1136/hrt.66.1.29.
All patients with suspected myocardial infarction admitted to hospital in four Birmingham health districts were studied to test the hypothesis that Asian patients would be overrepresented and Caribbean patients underrepresented compared with the indigenous population. One thousand four hundred and ninety six patients had a final diagnosis of myocardial infarction or severe angina pectoris. The relative risk of admission for Asian men compared with white men aged 45-64 years was 2.65 (95% confidence interval 2.20 to 3.19) and the risk for Asian men was high for both myocardial infarction and ischaemia when analysed separately. The relative risk of admission for Caribbean men compared with white men was 0.53 (95% CI 0.33 to 1.20). The relative risk for Asian women compared with white women in the same age group was 2.58 (95% CI 1.68 to 3.96), but this was due to an excess of admissions diagnosed as ischaemia rather than infarction in the Asian women. For Caribbean and white women the risk of admission was the same, although significantly fewer Caribbean women were admitted with myocardial infarction. The study was undertaken in 1986-87 and population data had to be derived from the 1981 census. The resident population changed in those five years and so the results were recalculated making allowances for these changes in the health districts involved. Based on these data the admission rate for Asian men with suspected myocardial infarction aged 45-64 was nearly twice that for white men (1.8): the relative risk of admission for Asian men compared with white men was 2.04 (95% CI 1.53 to 2.18). For Caribbean men the relative risk compared with white men was 0.45 (95% CI 0.29 to 0.71). For Asian women the relative risk of admission calculated from the adjusted census data resemble that in white women aged 45-64 years. The relative risk for admission with coronary heart disease in Asians is higher than expected work; one possible explanation for this is that the Asian population resident in the area under study was larger than estimated. The single major difference in risk factors was the high prevalence of diabetes mellitus in Asians (19.5% compared with 8.3% for white residents) but this did not wholly account for the excess of admissions from the Asian community.
对伯明翰四个卫生区医院收治的所有疑似心肌梗死患者进行了研究，以验证这一假设：与本地居民相比，亚洲患者在该群体中所占比例过高，而加勒比患者所占比例过低。1496名患者最终被诊断为心肌梗死或严重心绞痛。45至64岁的亚洲男性与白人男性相比，入院的相对风险为2.65（95%置信区间为2.20至3.19），单独分析时，亚洲男性患心肌梗死和局部缺血的风险都很高。加勒比男性与白人男性相比，入院的相对风险为0.53（95%置信区间为0.33至1.20）。同一年龄组的亚洲女性与白人女性相比，入院的相对风险为2.58（95%置信区间为1.68至3.96），但这是由于亚洲女性中被诊断为局部缺血而非梗死的入院人数过多。对于加勒比女性和白人女性来说，入院风险相同，尽管因心肌梗死入院的加勒比女性明显较少。该研究于1986 - 1987年进行，人口数据必须从1981年人口普查中获取。在这五年中，常住人口发生了变化，因此对涉及的卫生区的这些变化进行了调整后重新计算了结果。基于这些数据，45至64岁疑似心肌梗死的亚洲男性的入院率几乎是白人男性的两倍（1.8倍）：亚洲男性与白人男性相比，入院的相对风险为2.04（95%置信区间为1.53至2.18）。加勒比男性与白人男性相比，相对风险为0.45（95%置信区间为0.29至0.71）。根据调整后的人口普查数据计算出的亚洲女性入院相对风险与45至64岁白人女性的相似。亚洲人患冠心病入院的相对风险高于预期；对此的一个可能解释是，研究区域内的亚洲常住人口比估计的要多。风险因素的唯一主要差异是亚洲人糖尿病患病率高（19.5%，而白人居民为8.3%），但这并不能完全解释亚洲社区入院人数过多的情况。
