Department of Cardiology Houston Methodist DeBakey Heart & Vascular Center Houston TX.
Department of Cardiovascular Medicine Guthrie Health System/Robert Packer Hospital Sayre PA.
J Am Heart Assoc. 2022 Apr 5;11(7):e022857. doi: 10.1161/JAHA.121.022857. Epub 2022 Apr 1.
Background Life expectancy has been higher for Hispanic versus non-Hispanic White (NHW) individuals; however, data are limited on cardiovascular disease (CVD) mortality. Method and Results Using the Centers for Disease Control and Prevention's Wide-Ranging Online Data for Epidemiologic Research death certificate database (1999-2018), we compared age-adjusted mortality rates for total CVD and its subtypes (ischemic heart disease, stroke, heart failure, hypertensive heart disease, other CVD), and average annual percentage changes among Hispanic and NHW adults. The age-adjusted mortality rate per 100 000 was lower for Hispanic than NHW adults for total CVD (186.4 versus 254.6; <0.001) and its subtypes. Between 1999 and 2018, mortality decline was higher in Hispanic than NHW adults for total CVD (average annual percentage change [AAPC], -2.90 versus -2.41) and ischemic heart disease (AAPC: -4.44 versus -3.82) (<0.001). In contrast, stroke mortality decline was slower in Hispanic versus NHW adults (AAPC: -2.05 versus -2.60; <0.05). Stroke mortality increased in Hispanic but stalled in NHW adults since 2011 (AAPC: 0.79 versus -0.09). For ischemic heart disease (AAPC: -0.80 versus -1.85) and stroke (AAPC: -1.32 versus -1.43) mortality decline decelerated more for Hispanic than NHW adults aged <45 years (<0.05). For heart failure, Hispanic adults aged <45 (3.55 versus 2.16) and 45 to 64 (1.88 versus 1.54) showed greater rise in age-adjusted mortality rate than NHW individuals (<0.05). Age-adjusted heart failure mortality rate also accelerated in Hispanic versus NHW men (1.00 versus 0.67; <0.001). Conclusions Disaggregating data by CVD subtype and demographics unmasked heterogeneities in CVD mortality between Hispanic and NHW adults. NHW adults had greater CVD mortality rates and slower decline than Hispanic adults, whereas marked demographic differences in mortality signaled concerning trends among the Hispanic versus NHW population.
与非西班牙裔白人（NHW）相比，西班牙裔的预期寿命更高；然而，关于心血管疾病（CVD）死亡率的数据有限。
使用疾病控制和预防中心的广域在线流行病学研究死亡证明数据库（1999-2018 年），我们比较了西班牙裔和 NHW 成年人的总 CVD 及其亚型（缺血性心脏病、中风、心力衰竭、高血压性心脏病、其他 CVD）的年龄调整死亡率以及平均年变化百分比。与 NHW 成年人相比，西班牙裔成年人的总 CVD（186.4 与 254.6；<0.001）及其亚型的死亡率较低。在 1999 年至 2018 年期间，与 NHW 成年人相比，西班牙裔成年人的总 CVD（平均年变化百分比[AAPC]，-2.90 与-2.41）和缺血性心脏病（AAPC：-4.44 与-3.82）的死亡率下降幅度更高（<0.001）。相比之下，西班牙裔成年人的中风死亡率下降速度较慢（AAPC：-2.05 与-2.60；<0.05）。自 2011 年以来，西班牙裔成年人的中风死亡率上升，但 NHW 成年人的死亡率停滞不前（AAPC：0.79 与-0.09）。对于缺血性心脏病（AAPC：-0.80 与-1.85）和中风（AAPC：-1.32 与-1.43），年龄小于 45 岁的西班牙裔成年人的死亡率下降速度比 NHW 成年人更快（<0.05）。年龄小于 45 岁的西班牙裔心力衰竭（3.55 与 2.16）和 45 至 64 岁的西班牙裔心力衰竭（1.88 与 1.54）的年龄调整死亡率上升幅度大于 NHW 个体（<0.05）。与 NHW 男性相比，西班牙裔男性的心力衰竭死亡率也有所上升（1.00 与 0.67；<0.001）。
通过 CVD 亚型和人口统计学数据进行细分揭示了西班牙裔和 NHW 成年人之间 CVD 死亡率的异质性。NHW 成年人的 CVD 死亡率较高，死亡率下降速度较慢，而西班牙裔与 NHW 人群之间死亡率的显著差异表明存在令人担忧的趋势。
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