Department of Native Hawaiian Health, University of Hawai'i, Honolulu, HI, USA.
Department of Quantitative Health Sciences, University of Hawai'i, Honolulu, HI, USA.
J Racial Ethn Health Disparities. 2021 Aug;8(4):943-952. doi: 10.1007/s40615-020-00851-2. Epub 2020 Aug 31.
Cardiovascular disease (CVD) is the leading cause of death in the US. In Hawai'i, Filipinos and Native Hawaiians have the highest rates of CVD-related risk factors. CVD risk across these ethnic groups has not been examined. This cross-sectional study examines 10-year CVD risk as determined by the Framingham Risk Score (FRS) across ethnic groups in Hawai'i, controlling for clinical, demographic, and psychosocial factors.
This study includes secondary data analysis of the Kohala Health Research Project dataset. All non-pregnant adults (≥ 18 years of age) who resided in the community of interest during the study period were eligible to participate with 1462 participants completing the clinical examination and surveys. This analysis included clinical, demographic, and psychosocial variables. Ethnic differences were examined using the chi-squared test and one-way ANOVA. Multiple linear regression on FRS was conducted and least square means of FRS were calculated.
Data from 1146 individuals were analyzed. Participants were 44.4% Native Hawaiian, 15.4% Filipino, 15.3% Japanese, and 25% non-Hispanic White; 55.4% were female and had a mean age of 48.8 years. For males, the unadjusted Japanese mean FRS was significantly higher compared with the other ethnic groups. For females, Filipino and Japanese mean FRS were significantly higher compared with Native Hawaiians and non-Hispanic Whites. In the fully adjusted model, there were no ethnic group differences in FRS among males and Filipinos had significantly higher FRS compared with non-Hispanic White among females.
This cross-sectional community-based epidemiological study examined ethnic differences in CVD risk after adjusting for age, depression, social support, and acculturation. The results suggest that some ethnic differences in CVD risk persist even after controlling for confounders but that recalibration of risk assessment is necessary.
心血管疾病（CVD）是美国的主要死亡原因。在夏威夷，菲律宾人和夏威夷原住民的心血管疾病相关风险因素发病率最高。这些族裔群体的 CVD 风险尚未得到研究。本横断面研究通过弗雷明汉风险评分（FRS），在控制了临床、人口统计学和心理社会因素的情况下，考察了夏威夷族裔群体的 10 年 CVD 风险。
本研究对 Kohala 健康研究项目数据集进行了二次数据分析。所有在研究期间居住在感兴趣社区的非孕妇成年人（≥18 岁）有资格参加，共有 1462 名参与者完成了临床检查和调查。本分析包括临床、人口统计学和心理社会变量。使用卡方检验和单因素方差分析来检验族裔差异。对 FRS 进行多元线性回归，计算 FRS 的最小二乘均数。
分析了 1146 名个体的数据。参与者中 44.4%为夏威夷原住民，15.4%为菲律宾人，15.3%为日本人，25%为非西班牙裔白人；55.4%为女性，平均年龄为 48.8 岁。对于男性，未经调整的日本人平均 FRS 显著高于其他族裔群体。对于女性，菲律宾人和日本人的 FRS 平均值显著高于夏威夷原住民和非西班牙裔白人。在完全调整的模型中，男性之间的 FRS 没有族裔差异，而女性中的菲律宾人 FRS 明显高于非西班牙裔白人。
本基于社区的横断面流行病学研究在调整年龄、抑郁、社会支持和文化适应后，考察了 CVD 风险的族裔差异。结果表明，即使在控制了混杂因素后，CVD 风险的一些族裔差异仍然存在，但需要重新校准风险评估。
