Li Ka Shing Knowledge Institute, St Michael's Hospital, Toronto, Canada.
Curr Opin Cardiol. 2010 Mar;25(2):124-30. doi: 10.1097/HCO.0b013e328335fea4.
Ethnic minority groups constitute increasing proportions of the population in western countries. Heart failure is increasingly prevalent worldwide and is associated with significant morbidity and mortality. The purpose of this review is to discuss the limited data on heart failure in the ethnic minority groups.
South Asians have more coronary risk factors that may increase the risk for premature coronary heart disease leading to development of heart failure at a younger age. In the Chinese, hypertension remains an important cause of heart failure and recent data suggest that heart failure with preserved systolic function is common. African-Americans have a higher prevalence of heart failure than whites, present with heart failure at younger ages, and heart failure in them is less likely to be due to coronary heart disease. Findings from a randomized controlled trial conducted specifically on African-Americans support the addition of the combination of isosorbide dinitrate and hydralazine to standard medical regimen for black patients with heart failure. Aboriginal people are more likely than nonaboriginal people to have less access to healthcare and to have a higher disease burden for atherosclerosis. Heart failure is more prevalent in aboriginal than in the nonaboriginal counterparts.
There are important differences across ethnic groups in the causes of heart failure and response to treatment. Given the likely increasing frequency of heart failure in these populations and an increasingly multiethnic world, additional studies on heart failure across different ethnic groups are warranted.
少数民族群体在西方国家的人口中所占比例越来越大。心力衰竭在全球范围内日益普遍，并且与较高的发病率和死亡率相关。本文的目的是讨论少数族裔群体中心力衰竭的有限数据。
南亚人有更多的冠心病危险因素，这可能会增加早发冠心病的风险，导致心力衰竭在更年轻时发生。在中国人中，高血压仍然是心力衰竭的重要原因，最近的数据表明，收缩功能保留性心力衰竭较为常见。与白人相比，非裔美国人心力衰竭的患病率更高，发病年龄更小，且心力衰竭的发生不太可能是由于冠心病引起的。一项专门针对非裔美国人进行的随机对照试验的结果支持在标准的心力衰竭治疗方案中加入硝酸异山梨酯和肼屈嗪的联合治疗，适用于黑人患者。与非原住民相比，原住民更有可能获得较少的医疗保健服务，并且患有动脉粥样硬化的疾病负担更大。心力衰竭在原住民中的发病率高于非原住民。
心力衰竭的病因和治疗反应在不同种族群体之间存在重要差异。鉴于这些人群中心力衰竭的发生率可能会增加，并且世界上的人口日益多样化，因此有必要在不同的种族群体中进行更多的心力衰竭研究。
