Wu Jia-Rong, Song Eun Kyeung, Moser Debra K, Lennie Terry A
1 University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC, USA.
2 Department of Nursing, College of Medicine, University of Ulsan, Korea.
Eur J Cardiovasc Nurs. 2018 Apr;17(4):305-313. doi: 10.1177/1474515118755720. Epub 2018 Jan 31.
Heart failure is a chronic, burdensome condition with higher re-hospitalization rates in African Americans than Whites. Higher dietary antioxidant intake is associated with lower oxidative stress and improved endothelial function. Lower dietary antioxidant intake in African Americans may play a role in the re-hospitalization disparity between African American and White patients with heart failure.
The objective of this study was to examine the associations among race, dietary antioxidant intake, and cardiac event-free survival in patients with heart failure.
In a secondary analysis of 247 patients with heart failure who completed a four-day food diary, intake of alpha-carotene, beta-carotene, beta-cryptoxanthin, lutein, zeaxanthin, lycopene, vitamins C and E, zinc, and selenium were assessed. Antioxidant deficiency was defined as intake below the estimated average requirement for antioxidants with an established estimated average requirement, or lower than the sample median for antioxidants without an established estimated average requirement. Patients were followed for a median of one year to determine time to first cardiac event (hospitalization or death). Survival analysis was used for data analysis.
African American patients had more dietary antioxidant deficiencies and a shorter cardiac event-free survival compared with Whites ( p = .007 and p = .028, respectively). In Cox regression, race and antioxidant deficiency were associated with cardiac event-free survival before and after adjusting for covariates.
African Americans with heart failure had more dietary antioxidant deficiencies and shorter cardiac event-free survival than Whites. This suggests that encouraging African American patients with heart failure to consume an antioxidant-rich diet may be beneficial in lengthening cardiac event-free survival.
心力衰竭是一种慢性、负担沉重的疾病，非裔美国人的再住院率高于白人。较高的膳食抗氧化剂摄入量与较低的氧化应激和改善的内皮功能相关。非裔美国人较低的膳食抗氧化剂摄入量可能在非裔美国人和白人心力衰竭患者的再住院差异中起作用。
本研究的目的是检查心力衰竭患者的种族、膳食抗氧化剂摄入量和无心脏事件生存期之间的关联。
在对247名完成了为期四天食物日记的心力衰竭患者进行的二次分析中，评估了α-胡萝卜素、β-胡萝卜素、β-隐黄质、叶黄素、玉米黄质、番茄红素、维生素C和E、锌和硒的摄入量。抗氧化剂缺乏被定义为摄入量低于有既定估计平均需求量的抗氧化剂的估计平均需求量，或低于无既定估计平均需求量的抗氧化剂的样本中位数。对患者进行了为期一年的随访，以确定首次心脏事件（住院或死亡）的时间。使用生存分析进行数据分析。
与白人相比，非裔美国患者有更多的膳食抗氧化剂缺乏，且无心脏事件生存期更短（分别为p = 0.007和p = 0.028）。在Cox回归中，在调整协变量前后，种族和抗氧化剂缺乏与无心脏事件生存期相关。
与白人相比，患有心力衰竭的非裔美国人有更多的膳食抗氧化剂缺乏，且无心脏事件生存期更短。这表明鼓励患有心力衰竭的非裔美国患者食用富含抗氧化剂的饮食可能有助于延长无心脏事件生存期。
