International Centre for Circulatory Health, Imperial College, London, UK.
Ethn Dis. 2011 Spring;21(2):150-7.
Statins improve lipid profiles and reduce cardiovascular morbidity and mortality but there are few data on their relative effects in different ethnic groups.
We used data from the randomised, placebo-controlled Anglo-Scandinavian Cardiac Outcomes Trial-Lipid Lowering Arm (ASCOT-LLA) to conduct a prespecified comparison of the lipid-lowering efficacy of statin therapy among hypertensive participants from different ethnic groups in the UK and Ireland. The effects of atorvastatin (10 mg daily) and placebo on fasting plasma lipid profiles were compared in matched groups of Whites and Blacks (of African-Caribbean or African origin) and Whites and South Asians (from the Indian subcontinent), adjusting for placebo effect.
In the active treatment group, 156 Blacks and 72 South Asians were compared with 419 and 198 Whites, respectively. In multivariable analyses adjusted for baseline lipid levels and other potential confounders, atorvastatin reduced total cholesterol, low-density lipoprotein (LDL)-cholesterol and triglycerides from baseline in all ethnic groups. There were no clinically or statistically significant differences in the effect between Whites and Blacks or between Whites and South Asians after adjusting for placebo effect; similar proportions in each group achieved lipid targets. There was no significant effect of atorvastatin on high-density lipoprotein (HDL)-cholesterol in any group.
A standard dose of atorvastatin improved lipid profiles to a similar extent in Whites, Blacks and South Asians. Given the proven benefits of statins, these results suggest that, when used in standard doses, they are likely to be similarly effective for cardiovascular disease prevention in all ethnic groups.
他汀类药物可改善血脂谱并降低心血管发病率和死亡率，但关于它们在不同种族群体中的相对效果的数据较少。
我们使用随机、安慰剂对照的盎格鲁-斯堪的纳维亚心脏结局试验-降脂臂（ASCOT-LLA）的数据，在英国和爱尔兰的高血压参与者中，按族裔群体预先设定比较他汀类药物治疗的降脂效果。比较了阿托伐他汀（10 毫克/天）和安慰剂对禁食血浆脂质谱的影响，比较了匹配的白人和黑人（非裔加勒比或非洲裔）和白人和南亚人（来自印度次大陆）组，调整了安慰剂效应。
在活性治疗组中，与 419 名白人相比，分别比较了 156 名黑人（非裔加勒比或非洲裔）和 72 名南亚人；与 198 名白人相比，分别比较了 156 名黑人（非裔加勒比或非洲裔）和 72 名南亚人。在多变量分析中，根据基线血脂水平和其他潜在混杂因素进行调整，阿托伐他汀降低了所有族裔群体的总胆固醇、低密度脂蛋白（LDL）-胆固醇和甘油三酯。调整安慰剂效应后，白人与黑人或白人与南亚人之间的作用没有临床或统计学上的显著差异；每组中达到脂质目标的比例相似。阿托伐他汀对高密度脂蛋白（HDL）-胆固醇在任何组中均无显著影响。
标准剂量的阿托伐他汀可使白人、黑人和南亚人的血脂谱得到类似程度的改善。鉴于他汀类药物的已证实益处，这些结果表明，在标准剂量下，它们可能对所有族裔群体的心血管疾病预防同样有效。
