González Hector M, Tarraf Wassim, Rodríguez Carlos J, Gallo Linda C, Sacco Ralph L, Talavera Gregory A, Heiss Gerardo, Kizer Jorge R, Hernandez Rosalba, Davis Sonia, Schneiderman Neil, Daviglus Martha L, Kaplan Robert C
Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, MI.
Institute of Gerontology, Wayne State University, Detroit, MI.
Am Heart J. 2016 Jun;176:134-44. doi: 10.1016/j.ahj.2016.02.008. Epub 2016 Feb 19.
Seven national 2020 Strategic Impact Goals for cardiovascular health (Life's Simple 7 [LS7]) estimates for major ethnic/racial groups are available, but not for diverse Hispanics/Latinos. Herein, we describe and examine LS7 profiles of diverse Hispanic/Latino groups.
HCHS/SOL (analytic n = 15,825; ages 18-74 years) data were used to estimate LS7 metrics. LS7 metrics were operationalized as Ideal, Intermediate, or Poor and indexed as an additive score. We calculated Hispanic/Latino group and sex-specific prevalence estimates for LS7 metrics and used survey-based regression models to examine (1) associations between LS7 scores and pertinent sociocultural characteristics and (2) relationships between LS7 scores and coronary heart disease, and stroke and transient ischemic attacks prevalence.
Few HCHS/SOL participants met all 7 Ideal LS7 criteria (<1%), and a similarly small proportion did not meet any Ideal LS7 criteria (1.1%). We found significant variability in LS7 distributions between men and women and across HCHS/SOL Hispanic/Latino heritages. We also found a substantial sex-adjusted age gradient in LS7 cardiovascular health (ie, ≥4 Ideal LS7s). Finally, higher Ideal LS7 scores were associated with decreased odds of both coronary heart disease and self-reported stroke/transient ischemic attack; these associations persisted after model covariate adjustments.
Hispanic/Latino LS7s compared favorably with existing national estimates; however, we found areas for improvement. Several Hispanic/Latino LS7 strengths and weaknesses varied by sex and heritage, providing important information to guide targeted health promotion efforts toward achieving 2020 goals.
目前已有针对主要种族/族裔群体的2020年心血管健康七大国家战略影响目标(即“健康七要素”[LS7])的评估数据,但针对多样化的西班牙裔/拉丁裔群体的数据尚未可得。在此,我们描述并研究多样化西班牙裔/拉丁裔群体的LS7概况。
使用西班牙裔社区健康研究/拉丁裔研究(分析样本量n = 15,825;年龄18 - 74岁)的数据来估算LS7指标。LS7指标分为理想、中等或较差三个等级,并以累加得分进行索引。我们计算了LS7指标在西班牙裔/拉丁裔群体以及按性别分类的患病率估算值,并使用基于调查的回归模型来研究:(1)LS7得分与相关社会文化特征之间的关联;(2)LS7得分与冠心病、中风及短暂性脑缺血发作患病率之间的关系。
很少有西班牙裔社区健康研究/拉丁裔研究的参与者符合所有7项理想的LS7标准(<1%),同样只有一小部分人不符合任何一项理想的LS7标准(1.1%)。我们发现,男性和女性之间以及不同西班牙裔社区健康研究/拉丁裔研究血统的人群中,LS7分布存在显著差异。我们还发现,在LS7心血管健康方面(即≥4项理想的LS7指标)存在显著的性别调整年龄梯度。最后,理想的LS7得分越高,冠心病和自我报告的中风/短暂性脑缺血发作的几率越低;在模型进行协变量调整后,这些关联仍然存在。
与现有的国家评估相比,西班牙裔/拉丁裔的LS7情况较好;然而,我们也发现了需要改进的地方。西班牙裔/拉丁裔的LS7的几个优势和劣势因性别和血统而异,这为指导有针对性的健康促进努力以实现2020年目标提供了重要信息。