Mensah George A
Center for Translation Research and Implementation Science, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA; Division of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland, USA.
Glob Heart. 2016 Sep;11(3):365-367. doi: 10.1016/j.gheart.2016.09.002.
The MESA (Multi-Ethnic Study of Atherosclerosis) has been highly successful in investigating the prevalence, characteristics, and progression of subclinical cardiovascular disease (CVD) in a multiethnic American cohort of adult men and women free of CVD at baseline. MESA has also championed the use of novel biomarkers and emerging imaging techniques for the assessment of subclinical CVD and has created an extensive set of data that continues to fuel dozens of ongoing analyses. Insights from MESA include the first demonstration of ethnic differences in coronary artery calcification and its association with subclinical disease progression and incident CVD. Other findings include ethnic differences in the prevalence of pharmacological, behavioral, and lifestyle interventions for the primary prevention of CVD. MESA has also shown the association between residential neighborhood characteristics and behavioral and biomedical risk factors for CVD. This vast amount of data documenting ethnic differences in progression of subclinical CVD, diabetes, kidney disease, and pulmonary disease contrasts sharply with the relative scarcity of specific information that can pave the way for the elimination of racial and ethnic disparities. Intervention research, however, goes beyond the original objectives of MESA and other observational studies. The time has now come to build on the legacy of MESA by supporting rigorous intervention research that informs clinical and public health strategies as well as policy and environmental changes for eliminating racial and ethnic disparities in CVD and other chronic diseases and advancing the health of multiethnic communities.
动脉粥样硬化多民族研究（MESA）在调查美国一个多民族成年男女队列中亚临床心血管疾病（CVD）的患病率、特征和进展方面取得了巨大成功，这些参与者在基线时均无CVD。MESA还倡导使用新型生物标志物和新兴成像技术来评估亚临床CVD，并创建了大量数据，这些数据持续推动着数十项正在进行的分析。MESA的见解包括首次证明冠状动脉钙化的种族差异及其与亚临床疾病进展和CVD发病的关联。其他发现包括在CVD一级预防的药物、行为和生活方式干预患病率方面的种族差异。MESA还显示了居住社区特征与CVD行为和生物医学风险因素之间的关联。大量记录亚临床CVD、糖尿病、肾脏疾病和肺部疾病进展中种族差异的数据，与能够为消除种族和民族差异铺平道路的具体信息相对匮乏形成了鲜明对比。然而，干预研究超越了MESA和其他观察性研究的最初目标。现在是时候在MESA的遗产基础上，支持严格的干预研究了，这些研究可为临床和公共卫生策略以及政策和环境变化提供信息，以消除CVD和其他慢性病中的种族和民族差异，并促进多民族社区的健康。
