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拉美裔移民亚群心血管疾病危险因素的异质性:来自 2010 至 2018 年国家健康访谈调查的证据。

Heterogeneity in Cardiovascular Disease Risk Factors Among Latino Immigrant Subgroups: Evidence From the 2010 to 2018 National Health Interview Survey.

机构信息

Johns Hopkins School of Nursing Baltimore MD.

Division of General Medicine Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA.

出版信息

J Am Heart Assoc. 2023 May 16;12(10):e027433. doi: 10.1161/JAHA.122.027433. Epub 2023 May 9.

Abstract

Background The Latino population is a growing and diverse share of the US population. Previous studies have examined Latino immigrants as a homogenous group. The authors hypothesized that there would be heterogeneity in cardiovascular disease risk factors among Latino immigrant subgroups (from Mexico, Puerto Rico, Cuba, Dominican Republic, Central America, or South America) compared with non-Latino White adults. Methods and Results A cross-sectional analysis of the 2010 to 2018 National Health Interview Survey (NHIS) among 548 739 individuals was performed. Generalized linear models with Poisson distribution were fitted to compare the prevalence of self-reported hypertension, overweight/obesity, diabetes, high cholesterol, physical inactivity, and current smoking, adjusting for known confounders. The authors included 474 968 non-Latino White adults and 73 771 Latino immigrants from Mexico (59%), Puerto Rico (7%), Cuba (6%), Dominican Republic (5%), Central America (15%), and South America (9%). Compared with White adults, Mexican immigrants had the highest prevalence of overweight/obesity (prevalence ratio [PR], 1.17 [95% CI, 1.15-1.19]); Puerto Rican individuals had the highest prevalence of diabetes (PR, 1.63 [95% CI, 1.45-1.83]); individuals from Central America had the highest prevalence of high cholesterol (PR, 1.16 [95% CI, 1.04-1.28]); and individuals from the Dominican Republic had the highest prevalence of physical inactivity (PR, 1.25 [95% CI, 1.18-1.32]). All Latino immigrant subgroups were less likely to be smokers than White adults. Conclusions The authors observed advantages and disparities in cardiovascular disease risk factors among Latino immigrants. Aggregating data on Latino individuals may mask differences in cardiovascular disease risk and hinder efforts to reduce health disparities in this population. Study findings provide Latino group-specific actionable information and targets for improving cardiovascular health.

摘要

背景

拉丁裔人口是美国人口中增长最快、最多样化的群体。以前的研究将拉丁裔移民视为一个同质群体。作者假设,与非拉丁裔白种成年人相比,拉丁裔移民亚群(来自墨西哥、波多黎各、古巴、多米尼加共和国、中美洲或南美洲)的心血管疾病危险因素存在异质性。

方法和结果

对 2010 年至 2018 年全国健康访谈调查(NHIS)中的 548739 名个体进行了横断面分析。使用泊松分布的广义线性模型比较了自我报告的高血压、超重/肥胖、糖尿病、高胆固醇、身体活动不足和当前吸烟的患病率,同时调整了已知混杂因素。作者纳入了 474968 名非拉丁裔白种成年人和 73771 名来自墨西哥(59%)、波多黎各(7%)、古巴(6%)、多米尼加共和国(5%)、中美洲(15%)和南美洲(9%)的拉丁裔移民。与白种成年人相比,墨西哥移民超重/肥胖的比例最高(患病率比 [PR],1.17 [95%置信区间,1.15-1.19]);波多黎各个体的糖尿病患病率最高(PR,1.63 [95% CI,1.45-1.83]);中美洲个体的高胆固醇患病率最高(PR,1.16 [95% CI,1.04-1.28]);而多米尼加共和国个体的身体活动不足率最高(PR,1.25 [95% CI,1.18-1.32])。所有拉丁裔移民亚群的吸烟率均低于白种成年人。

结论

作者观察到拉丁裔移民的心血管疾病危险因素存在优势和差异。汇总拉丁裔个体的数据可能掩盖了心血管疾病风险的差异,并阻碍了为这一人群减少健康差距所做的努力。研究结果提供了针对改善心血管健康的拉丁裔群体特定的可操作信息和目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c699/10227289/7f89afe3f8e0/JAH3-12-e027433-g001.jpg

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