Goldstein Karen M, Melnyk S Dee, Zullig Leah L, Stechuchak Karen M, Oddone Eugene, Bastian Lori A, Rakley Susan, Olsen Maren K, Bosworth Hayden B
Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; Division of General Internal Medicine, Duke University, Durham, North Carolina.
Center of Excellence for Health Services Research in Primary Care, Durham Veterans Affairs Medical Center, Durham, North Carolina; Ambulatory Care Services, Durham Veterans Affairs Medical Center, Durham, North Carolina; University of North Carolina Eshelman School of Pharmacy, Chapel Hill, North Carolina.
Womens Health Issues. 2014 Sep-Oct;24(5):477-83. doi: 10.1016/j.whi.2014.05.005.
Cardiovascular disease (CVD) is the leading cause of mortality for U.S. women. Racial minorities are a particularly vulnerable population. The increasing female veteran population has an higher prevalence of certain cardiovascular risk factors compared with non-veteran women; however, little is known about gender and racial differences in cardiovascular risk factor control among veterans.
We used analysis of variance, adjusting for age, to compare gender and racial differences in three risk factors that predispose to CVD (diabetes, hypertension, and hyperlipidemia) in a cohort of high-risk veterans eligible for enrollment in a clinical trial, including 23,955 men and 1,010 women.
Low-density lipoprotein (LDL) values were higher in women veterans than men with age-adjusted estimated mean values of 111.7 versus 97.6 mg/dL (p < .01). Blood pressures (BPs) were higher among African-American than White female veterans with age-adjusted estimated mean systolic BPs of 136.3 versus 133.5 mmHg, respectively (p < .01), and diastolic BPs of 82.4 versus 78.9 mmHg (p < .01). African-American veterans with diabetes had worse BP, LDL values, and hemoglobin A1c levels, although the differences were only significant among men.
Female veterans have higher LDL cholesterol levels than male veterans and African-American veterans have higher BP, LDL cholesterol, and A1c levels than Whites after adjusting for age. Further examination of CVD gender and racial disparities in this population may help to develop targeted treatments and strategies applicable to the general population.
心血管疾病(CVD)是美国女性死亡的主要原因。少数族裔是特别脆弱的人群。与非退伍军人女性相比,退伍军人女性中某些心血管危险因素的患病率更高;然而,对于退伍军人中心血管危险因素控制方面的性别和种族差异知之甚少。
我们使用方差分析,并对年龄进行调整,以比较一组符合临床试验入组条件的高危退伍军人(包括23,955名男性和1,010名女性)在三种易患CVD的危险因素(糖尿病、高血压和高脂血症)方面的性别和种族差异。
退伍军人女性的低密度脂蛋白(LDL)值高于男性,年龄调整后的估计平均值分别为111.7与97.6mg/dL(p <.01)。非裔美国退伍军人女性的血压高于白人退伍军人女性,年龄调整后的估计平均收缩压分别为136.3与133.5mmHg(p <.01),舒张压分别为82.4与78.9mmHg(p <.01)。患有糖尿病的非裔美国退伍军人的血压、LDL值和糖化血红蛋白水平更差,尽管差异仅在男性中显著。
在调整年龄后,退伍军人女性的LDL胆固醇水平高于退伍军人男性,非裔美国退伍军人的血压、LDL胆固醇和糖化血红蛋白水平高于白人。对该人群中CVD性别和种族差异的进一步研究可能有助于制定适用于普通人群的针对性治疗方法和策略。