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抗高血压药物的使用:对心血管风险不平等的影响及干预机会

Antihypertensive Medication Use: Implications for Inequities in Cardiovascular Risk and Opportunities for Intervention.

作者信息

LeBrón Alana M, Schulz Amy J, Mentz Graciela, Gamboa Cindy, Reyes Angela

出版信息

J Health Care Poor Underserved. 2018;29(1):192-201. doi: 10.1353/hpu.2018.0013.

Abstract

Antihypertensive medication use protects against adverse health effects of hyper-tension. Residents of low-income urban communities are disproportionately Black and Latino, and may experience heightened cardiovascular health risks due to reduced medication use. We estimate the odds of antihypertensive medication use by race/ethnicity and socioeconomic position. Data are from the Healthy Environments Partnership Community Survey, restricted to 377 hypertensive participants. Antihypertensive medication use was defined as people with hypertension who were taking antihypertensive medication. Racial/ethnic and socioeconomic differences in medication use were examined using multivariate logistic regression. Odds of antihypertensive medication use were lower for people with incomes 1.00-1.99 times the poverty level (OR=0.75, p=.05) compared with those ≥2.00 times poverty, and for Latinos (OR=0.48, p<.01) and Whites (OR=0.50, p<.01) compared with Blacks. Findings suggest a need to improve hypertension screening and treatment for residents of low-to moderate-income urban communities, with attention to subgroups who may have limited health care access.

摘要

使用抗高血压药物可预防高血压对健康的不良影响。低收入城市社区的居民中黑人及拉丁裔比例过高,且可能因药物使用减少而面临更高的心血管健康风险。我们按种族/族裔和社会经济地位估算使用抗高血压药物的几率。数据来自健康环境伙伴关系社区调查,仅限于377名高血压参与者。抗高血压药物使用定义为正在服用抗高血压药物的高血压患者。使用多因素逻辑回归分析药物使用方面的种族/族裔和社会经济差异。与收入为贫困线2.00倍及以上的人群相比,收入为贫困线1.00 - 1.99倍的人群使用抗高血压药物的几率较低(比值比=0.75,p = 0.05);与黑人相比,拉丁裔(比值比=0.48,p<0.01)和白人(比值比=0.50,p<0.01)使用抗高血压药物的几率较低。研究结果表明,有必要改善低收入至中等收入城市社区居民的高血压筛查和治疗,尤其要关注那些可能获得医疗保健机会有限的亚群体。

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