Hickson DeMarc A, Wilhite Rachel L, Petrini Marcy F, White Wendy B, Burchfiel Cecil
Jackson State University, Jackson Heart Study, Coordinating Center, USA.
J Asthma. 2009 May;46(4):421-8. doi: 10.1080/02770900902846307.
The aims of this study were to investigate the baseline prevalence of and risk factors associated with asthma, classify asthma severity, and describe medication use in a population-based sample of African American men and women 21 to 84 years of age from the Jackson Heart Study (JHS). Participants provided responses to respiratory and medical history questions and a medication inventory and underwent spirometry and other clinical examinations. These data were used to examine the extent to which novel and traditional risk factors were associated with asthma. Of the 4,098 participants included in this analysis, 9.4% reported lifetime asthma (5.7% current, 3.7% former), and current asthma was higher in women (6.8%) than in men (3.8%). An additional 9.8% reported an attack of wheeze with shortness of breath or non-doctor confirmed asthma (i.e., "probable" asthma). The mean forced expiratory volume in 1 second (FEV(1))% predicted was lower in those reporting current asthma (women: 83.7 +/- 18.0; men: 75.2 +/- 16.8) compared to those not reporting asthma (women: 95.6 +/- 16.7; men: 91.7 +/- 16.0). Current and probable asthma was associated with lower serum cortisol levels and hypertension medication use, along with traditional risk factors (i.e., lower socio-economic status, higher global stress scores, obesity, and fair to poor perceived general health). Severe asthma was low among participants reporting current (9.8%), former (3.3%), and probable (4.9%) asthma. Asthma medication use was reported by nearly 60% of the participants reporting current asthma. Asthma in African American adults is associated with decreased serum cortisol, hypertension medication use, and considerable lung function impairment compared to those who did not report asthma. The prevalence of asthma in the JHS is lower than state and national estimates, although the estimates are not directly comparable. Furthermore, asthma is drastically underdiagnosed in this population.
本研究的目的是调查哮喘的基线患病率及相关危险因素，对哮喘严重程度进行分类，并描述杰克逊心脏研究（JHS）中21至84岁非裔美国男性和女性的基于人群样本中的药物使用情况。参与者回答了呼吸和病史问题以及药物清单，并接受了肺活量测定和其他临床检查。这些数据用于检验新的和传统的危险因素与哮喘相关的程度。在纳入本分析的4098名参与者中，9.4%报告有终生哮喘（5.7%为现患，3.7%为既往患），女性现患哮喘的比例（6.8%）高于男性（3.8%）。另有9.8%报告有喘息伴呼吸急促发作或未经医生确诊的哮喘（即“可能”哮喘）。报告现患哮喘者的1秒用力呼气量（FEV₁）预计值百分比均值（女性：83.7±18.0；男性：75.2±16.8）低于未报告哮喘者（女性：95.6±16.7；男性：91.7±16.0）。现患和可能哮喘与较低的血清皮质醇水平和高血压药物使用有关，以及与传统危险因素（即较低的社会经济地位、较高的总体压力评分、肥胖以及自我感觉一般健康状况为中等至较差）有关。在报告现患（9.8%）、既往患（3.3%）和可能（4.9%）哮喘的参与者中，重度哮喘的比例较低。近60%报告现患哮喘的参与者使用了哮喘药物。与未报告哮喘者相比，非裔美国成年人哮喘与血清皮质醇降低、高血压药物使用以及相当程度的肺功能损害有关。JHS中哮喘的患病率低于州和全国估计数，尽管这些估计数无法直接比较。此外，该人群中哮喘的诊断严重不足。
