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种族歧视与动脉僵硬度和颈动脉内膜中层厚度增加相关:ELSA-Brasil 研究。

Racial discrimination is associated with greater arterial stiffness and carotid intima-media thickness: the ELSA-Brasil study.

机构信息

Department of Preventive and Social Medicine, Faculdade de Medicina, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.

Postgraduate Program in Public Health, Faculdade de Medicina, Universidade Federal de Minas Gerais, Minas Gerais, Brazil.

出版信息

Ann Epidemiol. 2022 Aug;72:40-47. doi: 10.1016/j.annepidem.2022.03.009. Epub 2022 Mar 26.

Abstract

PURPOSE

The association between racial discrimination and subclinical cardiovascular markers remains under-examined. We aimed to investigate the association of race/skin color and racial discrimination with pulse wave velocity (PWV) and carotid intima-media thickness (c-IMT) in the Brazilian context.

METHODS

We used data from 13,284 participants from the Brazilian Longitudinal Study of Adult Health (ELSA-Brasil) baseline with information of PWV and 9850 for c-IMT. Self-reported race/skin color and perceived racial discrimination were the exposures. PWV and c-IMT were used continuously and categorizing according to cutoff that indicates increased cardiovascular risk. Linear and logistic regression models were used.

RESULTS

Experience of racial discrimination was reported by 7% of total participants, but this prevalence was much higher among Blacks than Browns (PWV sample: 31,9% vs. 6,1%; c-IMT sample: 33,7% vs. 6,8%). After adjustments for age, sex, and research center, Blacks and Browns presented higher means of PWV and c-IMT and had greater chances of PWV>10 m/s and c-IMT≥75th percentile than Whites. The magnitude of all these associations were higher among Blacks and Browns with racial discrimination. In final models adjusted for education this pattern of association remained the same, although an attenuation in the magnitude of the association has been observed.

CONCLUSIONS

Blacks and Browns presented worse profiles of subclinical cardiovascular markers compared to Whites and those exposed to racial discrimination seem to have an additional cardiovascular risk.

摘要

目的

种族歧视与亚临床心血管标志物之间的关联仍未得到充分研究。本研究旨在探讨巴西人群中种族/肤色和种族歧视与脉搏波速度(PWV)和颈动脉内膜中层厚度(c-IMT)的关系。

方法

我们使用巴西成人健康纵向研究(ELSA-Brasil)基线数据,其中包含 13284 名参与者的 PWV 信息和 9850 名参与者的 c-IMT 信息。种族/肤色和感知到的种族歧视是暴露因素。PWV 和 c-IMT 连续使用,并根据表示心血管风险增加的截止值进行分类。使用线性和逻辑回归模型。

结果

总参与者中有 7%报告了种族歧视经历,但在黑人和棕色人种中,这一比例要高得多(PWV 样本:31.9% vs. 6.1%;c-IMT 样本:33.7% vs. 6.8%)。调整年龄、性别和研究中心后,黑人和棕色人种的 PWV 和 c-IMT 平均值较高,PWV>10 m/s 和 c-IMT≥75 百分位的可能性较大。与白人相比,所有这些关联在黑人中更为明显,而在棕色人种和黑人中,存在种族歧视的人这种关联的程度更高。在调整教育程度的最终模型中,这种关联模式仍然相同,尽管关联的程度有所减弱。

结论

与白人相比,黑人和棕色人种的亚临床心血管标志物状况更差,而那些经历过种族歧视的人似乎面临着额外的心血管风险。

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