Clark Cari Jo, Alonso Alvaro, Spencer Rachael A, Pencina Michael, Williams Ken, Everson-Rose Susan A
Cari Jo Clark is with the Department of Medicine and the Division of Epidemiology and Community Health, School of Public Health, Program in Health Disparities Research, University of Minnesota, Minneapolis. Alvaro Alonso is with the Division of Epidemiology and Community Health, School of Public Health, University of Minnesota. Rachael A. Spencer is an independent researcher in Atlanta, GA. Michael Pencina is with the Clinical Research Unit and the Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC. Ken Williams is with KenAnCo Biostatistics, San Antonio, TX. Susan A. Everson-Rose is with the Department of Medicine and the Program in Health Disparities Research, University of Minnesota.
Am J Public Health. 2014 Dec;104(12):e108-15. doi: 10.2105/AJPH.2014.302148. Epub 2014 Oct 16.
We estimated the distribution of predicted long-term cardiovascular disease (CVD) risk among young adults in the United States.
Our data were derived from National Longitudinal Study of Adolescent Health participants (n = 14 333; average age: 28.9 years). We used a Framingham-derived risk prediction function to calculate 30-year risks of "hard" and "general" CVD by gender and race/ethnicity.
Average 30-year risks for hard and general CVD were 10.4% (95% confidence interval [CI] = 10.1%, 10.7%) and 17.3% (95% CI = 17.0%, 17.7%) among men and 4.4% (95% CI = 4.3%, 4.6%) and 9.2% (95% CI = 8.9%, 9.5%) among women. Average age-adjusted risks of hard and general CVD were higher among Blacks and American Indians than among Whites and lower among Asian/Pacific Islander women than White women. American Indian men continued to have a higher risk of general CVD after adjustment for socioeconomic status. Four percent of women (95% CI = 3.6%, 5.0%) and 26.2% of men (95% CI = 24.7%, 27.8%) had a 20% or higher risk of general CVD. Racial differences were detected but were not significant after adjustment for socioeconomic status.
Average CVD risk among young adults is high. Population-based prevention strategies and improved detection and treatment of high-risk individuals are needed to reduce the future burden of CVD.
我们估计了美国年轻成年人中预测的长期心血管疾病（CVD）风险分布情况。
我们的数据来源于青少年健康全国纵向研究的参与者（n = 14333；平均年龄：28.9岁）。我们使用源自弗雷明汉的风险预测函数，按性别和种族/族裔计算“严重”和“一般”CVD的30年风险。
男性中严重和一般CVD的平均30年风险分别为10.4%（95%置信区间[CI]=10.1%，10.7%）和17.3%（95%CI = 17.0%，17.7%），女性中分别为4.4%（95%CI = 4.3%，4.6%）和9.2%（95%CI = 8.9%，9.5%）。经年龄调整后，黑人及美国印第安人中严重和一般CVD的风险高于白人，亚太岛民女性中这两种风险低于白人女性。在对社会经济地位进行调整后，美国印第安男性患一般CVD的风险仍然较高。4%的女性（95%CI = 3.6%，5.0%）和26.2%的男性（95%CI = 24.7%，27.8%）患一般CVD的风险为20%或更高。检测到种族差异，但在对社会经济地位进行调整后差异不显著。
年轻成年人的平均CVD风险较高。需要基于人群的预防策略以及改善对高危个体的检测和治疗，以减轻未来CVD的负担。
