Mitchell B D, Hazuda H P, Haffner S M, Patterson J K, Stern M P
Department of Medicine, University of Texas Health Science Center, San Antonio 78284.
Circulation. 1991 Jan;83(1):45-51. doi: 10.1161/01.cir.83.1.45.
Mexican-American men experience reduced cardiovascular mortality compared with non-Hispanic white men. There is no corresponding ethnic difference in cardiovascular mortality in women. The difference in men could result either from a lower incidence of cardiovascular disease or a lower case fatality rate among Mexican-Americans. Although the incidence of cardiovascular disease in Mexican-Americans is unknown, we have collected data on prevalence of myocardial infarction in 5,148 individuals examined in the San Antonio Heart Study, a population-based survey of cardiovascular disease conducted between 1979 and 1988 in Mexican-Americans and non-Hispanic whites aged 25-64 years. Myocardial infarction was assessed by Minnesota-coded electrocardiograms and by a self-reported history of a physician-diagnosed heart attack. For both end points, the age-adjusted prevalence of myocardial infarction was lower in Mexican-American men than in non-Hispanic white men. After adjustment for age and diabetes status (present/absent), the odds of a myocardial infarction, as defined by either criterion, was approximately one third lower in Mexican-American men than in non-Hispanic white men (p = 0.06). In women, the prevalence of both myocardial infarction end points was slightly higher in Mexican-Americans than in non-Hispanic whites, although neither of these differences was significant. Although the ethnic differences in prevalence in this study were not statistically significant, their pattern parallels the pattern in the mortality due to cardiovascular diseases. Therefore, the results support the hypothesis that the reduced cardiovascular mortality rate observed in Mexican-American men reflects a lower incidence of myocardial infarction rather than a reduced case fatality rate because the latter would result in a higher prevalence.
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。女性在心血管疾病死亡率方面不存在相应的种族差异。男性之间的这种差异可能是由于墨西哥裔美国人心血管疾病发病率较低，或者是病死率较低。虽然墨西哥裔美国人的心血管疾病发病率尚不清楚，但我们收集了在圣安东尼奥心脏研究中接受检查的5148人的心肌梗死患病率数据，该研究是1979年至1988年对年龄在25 - 64岁的墨西哥裔美国人和非西班牙裔白人进行的一项基于人群的心血管疾病调查。心肌梗死通过明尼苏达编码心电图和医生诊断的心脏病发作的自我报告病史进行评估。对于这两个终点，墨西哥裔美国男性心肌梗死的年龄调整患病率低于非西班牙裔白人男性。在调整年龄和糖尿病状态（存在/不存在）后，根据任何一项标准定义的心肌梗死几率，墨西哥裔美国男性比非西班牙裔白人男性低约三分之一（p = 0.06）。在女性中，墨西哥裔美国人的两个心肌梗死终点患病率均略高于非西班牙裔白人，尽管这些差异均无统计学意义。虽然本研究中患病率的种族差异无统计学意义，但其模式与心血管疾病死亡率的模式相似。因此，结果支持了这样一种假设，即墨西哥裔美国男性中观察到的心血管疾病死亡率降低反映了心肌梗死发病率较低，而不是病死率降低，因为后者会导致更高的患病率。
