Wake Forest School of Medicine, Winston Salem, NC, USA.
Department of Internal Medicine, Wake Forest School of Medicine, Winston Salem, NC, USA.
J Natl Med Assoc. 2018 Apr;110(2):169-175. doi: 10.1016/j.jnma.2017.08.003. Epub 2017 Sep 13.
Heart age is an estimate of the age of a person's cardiovascular system given their cardiovascular disease (CVD) risk factors. The difference between a person's chronological age and heart age (excess heart age) represents their added CVD risk.
To examine racial differences in excess heart age and whether race impacts the association between excess heart age and CVD mortality.
This analysis included 5110 participants (2449 non-Hispanic white, 1287 non-Hispanic black, and 1374 Mexican-American) from the NHANES III who were free of CVD. Heart age was calculated using the sex-specific non-laboratory-based Framingham risk prediction functions. Multivariable Cox proportional-hazards regression models were used to evaluate the relationship (overall and by race) between excess heart age and CVD mortality.
Mean excess heart age was greatest in non-Hispanic blacks (13.0 years), followed by Mexican-Americans (10.5 years), and non-Hispanic whites (8.5 years); p < 0.001 for pairwise differences. Over a mean follow-up of 13.0 years, 394 CVD deaths occurred. Each 10 years of excess heart age was associated with 65% increased risk of CVD mortality (HR, 95% CI: 1.65, 1.53-1.78). This association was stronger in non-Hispanic whites (1.83, 1.63-2.02) compared to non-Hispanic blacks (1.50, 1.29-1.72) and Mexican American (1.60, 1.33-1.87), interaction p = 0.065.
Compared to non-Hispanic whites, non-Hispanic blacks and Mexican Americans have more excess heart age, but the risk of CVD death for the same level of excess heart age appears more pronounced in non-Hispanic whites. Further investigation is needed to show the usefulness of these findings in directing future efforts and resource allocation for reduction of health disparities between ethnic groups.
心脏年龄是根据一个人的心血管疾病（CVD）风险因素来估计其心血管系统年龄的一种方法。一个人的实际年龄与心脏年龄（多余的心脏年龄）之间的差异代表了他们额外的 CVD 风险。
检查心脏年龄的种族差异，以及种族是否会影响多余心脏年龄与 CVD 死亡率之间的关系。
这项分析包括来自 NHANES III 的 5110 名参与者（2449 名非西班牙裔白人、1287 名非西班牙裔黑人、1374 名墨西哥裔美国人），他们没有 CVD。心脏年龄是使用基于非实验室的 Framingham 风险预测函数计算的。多变量 Cox 比例风险回归模型用于评估（总体和按种族）多余心脏年龄与 CVD 死亡率之间的关系。
非西班牙裔黑人的平均多余心脏年龄最大（13.0 岁），其次是墨西哥裔美国人（10.5 岁）和非西班牙裔白人（8.5 岁）；两两比较，差异有统计学意义（p<0.001）。在平均 13.0 年的随访期间，发生了 394 例 CVD 死亡。多余心脏年龄每增加 10 年，CVD 死亡率的风险增加 65%（HR，95%CI：1.65，1.53-1.78）。这种关联在非西班牙裔白人中更强（1.83，1.63-2.02），而非西班牙裔黑人和墨西哥裔美国人中较弱（1.50，1.29-1.72；1.60，1.33-1.87），交互作用 p=0.065。
与非西班牙裔白人相比，非西班牙裔黑人和墨西哥裔美国人的多余心脏年龄更大，但在相同的多余心脏年龄水平下，CVD 死亡的风险在非西班牙裔白人中似乎更为明显。需要进一步研究这些发现的实用性，以指导未来减少不同族裔群体之间健康差距的努力和资源分配。
