老年人中心房颤动患病率的种族/民族差异——一项横断面研究。
Racial/ethnic differences in the prevalence of atrial fibrillation among older adults--a cross-sectional study.
机构信息
Department of Cardiology and the Center for Medical Education and Research, Kaiser Permanente Medical Center, Los Angeles, California 90027, USA.
出版信息
J Natl Med Assoc. 2010 Oct;102(10):906-13. doi: 10.1016/s0027-9684(15)30709-4.
BACKGROUND
Atrial fibrillation affects 4% to 8% of individuals over 60 years of age based on studies of predominantly white populations, whether this is true among nonwhite individuals is not clear. This study was undertaken to define racial/ethnic differences in atrial fibrillation prevalence among a large community cohort.
METHODS
This is a cross-sectional study. In 2008, there were 430,317 members aged 60 years or older in a large California health maintenance organization. By searching International Classification of Diseases, Ninth Revision codes and electronic electrocardiographic archives, we identified all members in this age group with primary, nonvalvular atrial fibrillation. Race/ethnicity data were assigned using health plan enrollment, service utilization, Asian/Hispanic surname and geocoding methods, and was available for 80.5% of members (79.8% of non-atrial fibrillation and 92% of atrial fibrillation), 99% of which were white, black, Asian, or Hispanic. We assessed the age- and gender-specific atrial fibrillation prevalence rates for each racial/ethnic group. The effect of race/ethnicity on atrial fibrillation was analyzed with logistic regression methods adjusting for potential confounders.
RESULTS
The overall atrial fibrillation prevalence was 5.3%. Among members with assigned race/ethnicity data, the prevalence among whites, blacks, Asians, and Hispanics was 8.0%, 3.8%, 3.9%, and 3.6%, respectively. The adjusted odds ratios (95% confidence intervals) of atrial fibrillation among blacks, Asians, and Hispanics with whites as referent were 0.49 (0.47-0.52), 0.68 (0.64-0.72), and 0.58 (0.55-0.61), respectively.
CONCLUSIONS
Atrial fibrillation is less prevalent in older nonwhite individuals than whites. White race/ethnicity is associated with significantly greater odds for atrial fibrillation compared to blacks, Asians, and Hispanics, after adjusting for comorbidities associated with the development of atrial fibrillation.
背景
根据主要针对白人群体的研究，60 岁以上人群中房颤的发病率为 4%至 8%，但在非白人群体中是否如此尚不清楚。本研究旨在确定大型社区队列中房颤患病率的种族/民族差异。
方法
这是一项横断面研究。2008 年，一家大型加利福尼亚健康维护组织有 430317 名 60 岁或以上的成员。通过搜索国际疾病分类，第九修订版代码和电子心电图档案，我们确定了该年龄段中患有原发性、非瓣膜性房颤的所有成员。种族/民族数据使用健康计划登记、服务利用、亚裔/西班牙裔姓氏和地理编码方法进行分配，80.5%的成员（非房颤 79.8%，房颤 92%）可获得种族/民族数据，其中 99%为白种人、黑种人、亚洲人或西班牙裔。我们评估了每个种族/民族组的年龄和性别特异性房颤患病率。使用逻辑回归方法分析种族/民族对房颤的影响，并调整了潜在混杂因素。
结果
总体房颤患病率为 5.3%。在有分配种族/民族数据的成员中，白种人、黑种人、亚洲人和西班牙裔的房颤患病率分别为 8.0%、3.8%、3.9%和 3.6%。以白种人为参照，黑种人、亚洲人和西班牙裔患房颤的调整后优势比（95%置信区间）分别为 0.49（0.47-0.52）、0.68（0.64-0.72）和 0.58（0.55-0.61）。
结论
与白人相比，老年非白人个体的房颤患病率较低。在调整与房颤发生相关的合并症后，与黑人、亚洲人和西班牙裔相比，白人种族/民族与房颤发生的几率显著增加。
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