Department of Medicine, University of Florida, Gainesville, FL, USA.
Int J Gen Med. 2014 Aug 7;7:393-400. doi: 10.2147/IJGM.S65528. eCollection 2014.
This is a comprehensive narrative review of the literature on the current science and evidence of population-level differences in risk factors for heart disease among different racial and ethnic population in the US. It begins by discussing the importance of population-level risk assessment of heart disease in light of the growth rate of specific minority populations in the US. It describes the population-level dynamics for racial and ethnic minorities: a higher overall prevalence of risk factors for coronary artery disease that are unrecognized and therefore not treated, which increases their likelihood of experiencing adverse outcomes and, therefore, potentially higher morbidity and mortality. It discusses the rate of acute coronary syndrome (ACS) in minority communities. Minority patients with ACS are at greater risk of myocardial infarction, rehospitalization, and death from ACS. They also are less likely than nonminority patients to receive potentially beneficial treatments such as angiography or percutaneous coronary intervention. This paper looks at the data surrounding the increased rate of congestive heart failure in racial and ethnic minorities, where the risk is related to the prevalence of comorbidities with hypertension or diabetes mellitus, which, in combination with environmental factors, may largely explain congestive heart failure disparity. The conclusion is it is essential that health care providers understand these various communities, including nuances in disease presentation, risk factors, and treatment among different racial and ethnic groups. Awareness of these communities' attributes as well as differences in incidence, risk factor burdens, prognosis, and treatment are necessary to mitigate racial and ethnic disparities in heart disease.
这是一篇关于美国不同种族和民族人群中心血管疾病风险因素的当前科学和证据的综合文献综述。它首先讨论了根据美国特定少数族裔人口增长率进行人群水平心脏病风险评估的重要性。本文描述了种族和少数民族的人群水平动态：整体上冠心病风险因素的总体患病率较高，这些风险因素未被识别，因此未得到治疗，这增加了他们出现不良后果的可能性，因此，可能会导致更高的发病率和死亡率。本文还讨论了少数族裔社区中急性冠状动脉综合征（ACS）的发生率。少数族裔 ACS 患者发生心肌梗死、再住院和 ACS 死亡的风险更高。与非少数族裔患者相比，他们接受潜在有益治疗（如血管造影或经皮冠状动脉介入治疗）的可能性也较低。本文研究了与高血压或糖尿病等合并症相关的心血管疾病风险增加的种族和民族差异背后的数据，这些因素与充血性心力衰竭的风险有关，这些风险因素与环境因素相结合，可能在很大程度上解释了充血性心力衰竭的差异。结论是，医疗保健提供者必须了解这些不同的群体，包括不同种族和民族人群中疾病表现、风险因素和治疗方法的细微差别。了解这些社区的特征以及发病率、风险因素负担、预后和治疗方面的差异，对于减轻心脏病的种族和民族差异至关重要。
