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种族、民族和国籍在评估有妊娠高血压疾病史女性心血管风险研究中的应用。

Use of Race, Ethnicity, and National Origin in Studies Assessing Cardiovascular Risk in Women With a History of Hypertensive Disorders of Pregnancy.

作者信息

Johnston Amy, Tseung Victrine, Dancey Sonia R, Visintini Sarah M, Coutinho Thais, Edwards Jodi D

机构信息

School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Ontario, Canada.

Division of Cardiac Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.

出版信息

CJC Open. 2021 Aug 20;3(12 Suppl):S102-S117. doi: 10.1016/j.cjco.2021.08.002. eCollection 2021 Dec.

Abstract

Women with a history of hyperBtensive disorders of pregnancy (HDP) are at particularly high risk for cardiovascular disease (CVD) and CVD-related death, and certain racial and ethnic subpopulations are disproportionately affected by these conditions. We examined the use of race, ethnicity, and national origin in observational studies assessing CVD morbidity and mortality in women with a history of HDP. A total of 124 studies, published between 1976 and 2021, were reviewed. We found that white women were heavily overrepresented, encompassing 53% of all participants with HDP. There was limited and heterogeneous reporting of race and ethnicity information across studies and only 27 studies reported including race and/or ethnicity variables in at least 1 statistical analysis. Only 2 studies mentioned the use of these variables as a strength; several others (k = 18) reported a lack of diversity among participants as a study limitation. Just over half of included articles (k = 68) reported at least 1 sociodemographic variable other than race and ethnicity (eg, marital status and income); however, none investigated how they might have worked synergistically or antagonistically with race and/or ethnicity to influence participants' risk of CVD. These findings highlight significant areas for improvement in cardiovascular obstetrics research, including the need for more robust and standardized methods for collecting, reporting, and using sociodemographic information. Future studies of CVD risk in women with a history of HDP should explicitly examine racial and ethnic differences and use an intersectional approach.

摘要

有妊娠期高血压疾病(HDP)病史的女性患心血管疾病(CVD)及CVD相关死亡的风险特别高,某些种族和族裔亚人群受这些疾病的影响尤为严重。我们研究了在评估有HDP病史女性CVD发病率和死亡率的观察性研究中种族、族裔和国籍的使用情况。共回顾了1976年至2021年间发表的124项研究。我们发现白人女性的占比严重过高,占所有有HDP病史参与者的53%。各研究中关于种族和族裔信息的报告有限且参差不齐,只有27项研究报告在至少一项统计分析中纳入了种族和/或族裔变量。只有2项研究提到将这些变量作为优势;其他几项研究(k = 18)报告称参与者缺乏多样性是一项研究局限。略超过一半的纳入文章(k = 68)报告了至少一项除种族和族裔之外的社会人口统计学变量(如婚姻状况和收入);然而,没有一项研究调查这些变量可能如何与种族和/或族裔协同或拮抗作用以影响参与者的CVD风险。这些发现凸显了心血管产科研究中亟待改进的重要领域,包括需要更完善和标准化的方法来收集、报告和使用社会人口统计学信息。未来对有HDP病史女性的CVD风险研究应明确检查种族和族裔差异,并采用交叉性方法。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/ad47/8712581/c7cebeb54f45/gr1.jpg

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