Perini W, Snijder M B, Peters R J G, Kunst A E
Department of Public Health, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
Department of Cardiology, Academic Medical Center Amsterdam, Amsterdam, The Netherlands.
Neth Heart J. 2018 May;26(5):252-262. doi: 10.1007/s12471-018-1107-3.
Ethnic differences have been reported in cardiovascular disease (CVD) risk factors. It is still unclear which ethnic groups are most at risk for CVD when all traditional CVD risk factors are considered together as overall risk.
To examine ethnic differences in overall estimated CVD risk and the risk factors that contribute to these differences.
Using data of the multi-ethnic HELIUS study (HEalthy LIfe in an Urban Setting) from Amsterdam, we examined whether estimated CVD risk and risk factors among those eligible for CVD risk estimation differed between participants of Dutch, South Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan origin. Using the Systematic COronary Risk Evaluation (SCORE) algorithm, we estimated risk of fatal CVD and risk of fatal plus non-fatal CVD. These risks were compared between ethnic groups via age-adjusted linear regression analyses.
The SCORE algorithm was applicable to 9,128 participants. Relative to the fatal CVD risk of participants of Dutch origin, South Asian Surinamese participants showed a higher fatal CVD risk, Ghanaian males a lower fatal CVD risk, and participants of other ethnic origins a similar fatal CVD risk. For fatal plus non-fatal CVD risk, African Surinamese and Turkish men also showed a higher risk. When diabetes was incorporated in the CVD risk algorithm, all but Ghanaian men showed a higher CVD risk relative to the participants of Dutch origin (betas ranging from 0.98-3.10%). The CVD risk factors that contribute the most to these ethnic differences varied between ethnic groups.
Ethnic minority groups are at a greater estimated risk of fatal plus non-fatal CVD relative to the group of native Dutch. Further research is necessary to determine whether this will translate to ethnic differences in CVD incidence and, if so, whether ethnic-specific CVD prevention strategies are warranted.
心血管疾病（CVD）风险因素存在种族差异。当将所有传统的CVD风险因素作为整体风险综合考虑时，哪些种族群体患CVD的风险最高仍不清楚。
研究整体估计的CVD风险中的种族差异以及导致这些差异的风险因素。
利用来自阿姆斯特丹的多民族HELIUS研究（城市环境中的健康生活）的数据，我们研究了符合CVD风险评估条件的参与者中，荷兰、南亚苏里南人、非洲苏里南人、加纳人、土耳其人和摩洛哥人血统的参与者在估计的CVD风险和风险因素方面是否存在差异。使用系统性冠状动脉风险评估（SCORE）算法，我们估计了致命性CVD风险以及致命性加非致命性CVD风险。通过年龄调整的线性回归分析比较了不同种族群体之间的这些风险。
SCORE算法适用于9128名参与者。相对于荷兰血统参与者的致命性CVD风险，南亚苏里南人参与者的致命性CVD风险更高，加纳男性的致命性CVD风险更低，其他种族血统的参与者的致命性CVD风险相似。对于致命性加非致命性CVD风险，非洲苏里南人和土耳其男性也表现出更高的风险。当将糖尿病纳入CVD风险算法时，除加纳男性外，所有其他群体相对于荷兰血统参与者均表现出更高的CVD风险（β值范围为0.98 - 3.10%）。导致这些种族差异的CVD风险因素在不同种族群体之间各不相同。
相对于荷兰本土群体，少数族裔群体患致命性加非致命性CVD的估计风险更高。有必要进行进一步研究以确定这是否会转化为CVD发病率的种族差异，如果是，是否需要制定针对特定种族的CVD预防策略。
