Atzema Clare L, Khan Saba, Lu Hong, Allard Yvon E, Russell Storm J, Gravelle Mario R, Klein-Geltink Julie, Austin Peter C
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada; Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada; University of Toronto, Toronto, Ontario, Canada.
Institute for Clinical Evaluative Sciences, Toronto, Ontario, Canada.
PLoS One. 2015 Mar 20;10(3):e0121779. doi: 10.1371/journal.pone.0121779. eCollection 2015.
The burden of cardiovascular disease in the Métis, Canada's fastest growing Aboriginal group, is not well studied. We determined rates of five cardiovascular diseases and associated outcomes in Ontario Métis, compared to the general Ontario population.
Métis persons were identified using the Métis Nation of Ontario Citizenship Registry. Métis citizens aged 20-105 were linked to Ontario health databases for the period of April 2006 to March 2011. Age- and sex-standardized prevalence and incidence of acute coronary syndromes (ACS), congestive heart failure (CHF), cerebrovascular disease (stroke), atrial fibrillation, and hypertension were compared between the Métis and the general population. Secondary outcome measures included one-year hospitalizations and mortality following the incident cardiovascular diagnosis, as well as quality-of-care measures.
There were 12,550 eligible Métis persons and 10,144,002 in the general population. The adjusted prevalence of each disease was higher (p<0.05) among the Métis compared to the general population: ACS 5.3% vs. 3.0%; CHF 5.1% vs. 3.9%; stroke 1.4% vs. 1.1%; atrial fibrillation 2.1% vs. 1.4%; hypertension 34.9% vs. 29.8%. Incident ACS, stroke, and atrial fibrillation were also higher (p<0.05) among the Métis: ACS 2.4% vs. 1.5%; stroke 0.8% vs. 0.6%; atrial fibrillation 0.6% vs. 0.3%. One-year all-cause and cardiovascular-related mortality were not significantly different. Hospitalizations were higher for Métis persons with CHF (OR 1.93; 95% CI 1.34-2.78) and hypertension (OR 2.27; 95% CI 1.88-2.74). Métis with CHF made more emergency department (ED) visits in the year after diagnosis compared to non-Métis with CHF, while Métis aged ≥65 with ACS were more likely to be on beta-blockers following diagnosis.
The burden of cardiovascular disease was markedly higher in the Métis compared to the general population: prevalence rates for five cardiovascular conditions were 25% to 77% higher. Métis persons with CHF had more frequent hospitalizations and ED visits following their diagnosis.
加拿大增长最快的原住民群体梅蒂斯人患心血管疾病的负担尚未得到充分研究。我们确定了安大略省梅蒂斯人患五种心血管疾病及其相关后果的比率，并与安大略省普通人群进行了比较。
利用安大略省梅蒂斯民族公民登记册来识别梅蒂斯人。2006年4月至2011年3月期间，年龄在20 - 105岁的梅蒂斯公民与安大略省的健康数据库进行了关联。比较了梅蒂斯人和普通人群中急性冠状动脉综合征（ACS）、充血性心力衰竭（CHF）、脑血管疾病（中风）、心房颤动和高血压的年龄和性别标准化患病率及发病率。次要结局指标包括心血管疾病确诊后的一年住院率和死亡率，以及医疗质量指标。
有12550名符合条件的梅蒂斯人，普通人群有10144002人。与普通人群相比，梅蒂斯人中每种疾病的校正患病率更高（p<0.05）：ACS为5.3% 对3.0%；CHF为5.1% 对3.9%；中风为1.4% 对1.1%；心房颤动为2.1% 对1.4%；高血压为34.9% 对29.8%。梅蒂斯人中ACS、中风和心房颤动的发病率也更高（p<0.05）：ACS为2.4% 对1.5%；中风为0.8% 对0.6%；心房颤动为0.6% 对0.3%。全因死亡率和心血管疾病相关死亡率无显著差异。CHF（比值比1.93；95%置信区间1.34 - 2.78）和高血压（比值比2.27；95%置信区间1.88 - 2.74）的梅蒂斯人住院率更高。与非梅蒂斯CHF患者相比，梅蒂斯CHF患者在确诊后的一年中急诊就诊次数更多，而≥65岁的梅蒂斯ACS患者在确诊后更有可能使用β受体阻滞剂。
与普通人群相比，梅蒂斯人患心血管疾病的负担明显更高：五种心血管疾病的患病率高出25%至77%。梅蒂斯CHF患者确诊后住院和急诊就诊更为频繁。
