Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, OH, USA.
Am Heart J. 2009 Dec;158(6):1038-45. doi: 10.1016/j.ahj.2009.09.014.
Prior investigations to define ethnic-related differences in the risks, medical treatment, and outcomes of patients with peripheral arterial disease (PAD) have been limited.
The impact of ethnicity on the risk factor profiles, use of evidence-based medical therapies, and 2-year cardiovascular outcomes were investigated in 2,168 individuals (blacks n = 237, Hispanics n = 115, whites n = 1,816) from the United States with PAD from the international Reduction of Atherothrombosis for Continued Health Registry.
Blacks and Hispanics were more likely to have diabetes mellitus and hypertension, whereas whites had a higher rate of diagnosed hypercholesterolemia. Control of blood pressure and cholesterol levels differed significantly in the groups at baseline: elevated blood pressure was present in 55% of blacks versus 48% of Hispanics versus 38% of whites (P < .01), whereas 41% of blacks versus 31% of Hispanics versus 25% of whites had elevated total cholesterol (P < .01). Aspirin use (62% of blacks vs 68% of Hispanics vs 72% of whites, P < .01) and statin use (72% of blacks vs 68% of Hispanics vs 77% of whites, P = .03) also varied significantly. In this context, rates by ethnicity for cardiovascular death, myocardial infarction, or stroke seemed to be no different at 2 years, at 8.8% for the total population: 11.6% for blacks, 8.5% for whites, and 5.0% for Hispanics (P = .32). Fewer blacks (0.6%) had undergone peripheral arterial bypass surgery compared with whites (3.4%) and Hispanics (5.2%) (P = .02).
Ethnic-related differences have been documented in the prevalence and treatment of several atherosclerotic risk factors known to be associated with PAD, including a variation in the use of surgical revascularization procedures.
先前的研究已经对不同种族之间外周动脉疾病（PAD）患者的风险、医疗和结局差异进行了定义。
该研究纳入了来自国际减少动脉粥样硬化血栓形成以持续健康注册研究（Reduction of Atherothrombosis for Continued Health Registry）的 2168 名美国 PAD 患者（黑人 237 名，西班牙裔 115 名，白人 1816 名），评估了种族对其危险因素谱、循证医学治疗应用和 2 年心血管结局的影响。
黑人及西班牙裔患者更易患糖尿病和高血压，而白人患者更易被诊断为高胆固醇血症。各组患者的血压和胆固醇水平在基线时存在显著差异：高血压患者分别占黑人患者的 55%、西班牙裔患者的 55%和白人患者的 48%（P <.01），而黑人患者中有 41%、西班牙裔患者中有 31%、白人患者中有 25%的总胆固醇升高（P <.01）。阿司匹林使用率（黑人患者为 62%、西班牙裔患者为 68%、白人患者为 72%，P <.01）和他汀类药物使用率（黑人患者为 72%、西班牙裔患者为 68%、白人患者为 77%，P =.03）也存在显著差异。在此背景下，在 2 年时，心血管死亡、心肌梗死或卒中的发生率似乎在不同种族间无差异，总体发生率为 8.8%：黑人患者为 11.6%，白人患者为 8.5%，西班牙裔患者为 5.0%（P =.32）。与白人（3.4%）和西班牙裔（5.2%）患者相比，黑人患者（0.6%）接受外周动脉旁路手术的比例较少（P =.02）。
在与 PAD 相关的几种动脉粥样硬化危险因素的流行和治疗方面，已发现种族间存在差异，包括血管重建手术应用的差异。
