Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL
Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, IL.
J Am Heart Assoc. 2017 Sep 22;6(9):e006027. doi: 10.1161/JAHA.117.006027.
In the United States, there are persistent racial and ethnic disparities in cardiovascular disease morbidity and mortality. National efforts have focused on reducing these disparities; however, little is known about the long-term trends in racial/ethnic disparities in cardiovascular health (CVH).
We included 11 285 adults aged ≥20 years from the National Health and Nutrition Examination Surveys survey cycles 1999/2000 through 2011/2012. CVH includes 7 health factors and behaviors-diet, physical activity, smoking status, body mass index, blood pressure, blood glucose, and total cholesterol-each scored as ideal (2 points), intermediate (1 point), or poor (0 points). Overall CVH is a summation of these scores (range, 0-14) points. Age-adjusted mean CVH scores were calculated by race/ethnicity (non-Hispanic black, non-Hispanic white, or Mexican American) and sex for each survey cycle. Non-Hispanic black women had significantly lower mean CVH scores as compared with non-Hispanic white women at each survey cycle (difference=0.93; =0.001 in 2011/2012) and Mexican-American women had significantly lower mean score as compared with non-Hispanic white women at almost all survey cycles (difference=0.71; =0.02 in 2011/2012). Differences between racial/ethnic groups were smaller for men and were mostly nonsignificant.
From 1999/2000 to 2011/2012, there were enduring disparities in CVH for non-Hispanic black and Mexican-American women as compared with non-Hispanic white women. Disparities that were present in 1999/2000 were present in 2011/2012, though no racial/ethnic differences became more pronounced over time. These findings provide US nationally representative data to evaluate health factors and behaviors of particular concern regarding racial/ethnic disparities in cardiovascular health.
在美国，心血管疾病的发病率和死亡率存在持续的种族和民族差异。国家一直在努力减少这些差异；然而，对于心血管健康（CVH）方面的种族/民族差异的长期趋势知之甚少。
我们纳入了来自国家健康和营养检查调查 1999/2000 年至 2011/2012 年调查周期的 11285 名年龄≥20 岁的成年人。CVH 包括 7 个健康因素和行为——饮食、身体活动、吸烟状况、体重指数、血压、血糖和总胆固醇——每个因素都被评为理想（2 分）、中等（1 分）或差（0 分）。总体 CVH 是这些分数的总和（范围为 0-14）。根据每个调查周期的种族/民族（非西班牙裔黑人、非西班牙裔白人或墨西哥裔美国人）和性别计算出调整年龄后的平均 CVH 分数。在每个调查周期中，非西班牙裔黑人女性的平均 CVH 分数明显低于非西班牙裔白人女性（差值=0.93；2011/2012 年差异=0.001），而墨西哥裔美国女性的平均分数明显低于非西班牙裔白人女性，几乎在所有调查周期中（差值=0.71；2011/2012 年差异=0.02）。男性之间的种族/民族差异较小，且大多无统计学意义。
从 1999/2000 年到 2011/2012 年，非西班牙裔黑人和墨西哥裔美国女性与非西班牙裔白人女性相比，CVH 持续存在差异。1999/2000 年存在的差异在 2011/2012 年仍然存在，尽管随着时间的推移，没有任何种族/民族差异变得更加明显。这些发现为评估心血管健康方面的种族/民族差异提供了具有全国代表性的数据，这些数据涉及与健康因素和行为有关的特别关注问题。
