Department of Cardiology, Te Whatu Ora Health New Zealand Te Tai Tokerau, Whangarei, New Zealand
Section of Epidemiology and Biostatistics, The University of Auckland, Auckland, New Zealand.
Heart. 2024 Jan 29;110(4):281-289. doi: 10.1136/heartjnl-2023-322795.
Ethnic inequities in heart failure (HF) have been documented in several countries. This study describes New Zealand (NZ) trends in incident HF hospitalisation by ethnicity between 2006 and 2018.
Incident HF hospitalisations in ≥20-year-old subjects were identified through International Classification of Diseases, 10th Revision-coded national hospitalisation records. Incidence was calculated for different ethnic, sex and age groups and were age standardised. Trends were estimated with joinpoint regression.
Of 116 113 incident HF hospitalisations, 12.8% were Māori, 5.7% Pacific people, 3.0% Asians and 78.6% Europeans/others. 64% of Māori and Pacific patients were aged <70 years, compared with 37% of Asian and 19% of European/others. In 2018, incidence rate ratios compared with European/others were 6.0 (95% CI 4.9 to 7.3), 7.5 (95% CI 6.0 to 9.4) and 0.5 (95% CI 0.3 to 0.8) for Māori, Pacific people and Asians aged 20-49 years; 3.7 (95% CI 3.4 to 4.0), 3.6 (95% CI 3.2 to 4.1) and 0.5 (95% CI 0.4 to 0.6) for Māori, Pacific people and Asians aged 50-69 years; and 1.5 (95% CI 1.4 to 1.6), 1.5 (95% CI 1.3 to 1.7) and 0.5 (95% CI 0.5 to 0.6) for Māori, Pacific people and Asians aged ≥70 years. Between 2006 and 2018, ethnicity-specific rates diverged in ≥70-year-old subjects due to a decline in European/others (annual percentage change (APC) -2.0%, 95% CI -2.5% to -1.6%) and Asians (APC -3.3%, 95% CI -4.4% to -2.1%), but rates remained unchanged for Māori and Pacific people. In contrast, regardless of ethnicity, rates either increased or remained unchanged in <70-year-old subjects.
Ethnic inequities in incident HF hospitalisation have widened in NZ over the past 13 years. Urgent action is required to address the predisposing factors that lead to development of HF in Maori and Pacific people.
在多个国家都记录到了心力衰竭（HF）方面的族裔不平等现象。本研究描述了 2006 年至 2018 年间新西兰（NZ）不同族裔因 HF 住院的发病趋势。
通过国际疾病分类，第 10 版编码的国家住院记录，确定≥20 岁患者的 HF 入院事件。为不同的族裔、性别和年龄组计算发病率，并进行年龄标准化。使用连接点回归估计趋势。
在 116113 例 HF 入院事件中，12.8%为毛利人，5.7%为太平洋岛民，3.0%为亚洲人，78.6%为欧洲/其他族裔。与欧洲/其他族裔相比，64%的毛利人和太平洋岛民患者年龄<70 岁，而亚洲人占 37%，欧洲/其他族裔占 19%。2018 年，与欧洲/其他族裔相比，20-49 岁的毛利人、太平洋岛民和亚洲人发病率比分别为 6.0（95%CI 4.9 至 7.3）、7.5（95%CI 6.0 至 9.4）和 0.5（95%CI 0.3 至 0.8）；50-69 岁的毛利人、太平洋岛民和亚洲人发病率比分别为 3.7（95%CI 3.4 至 4.0）、3.6（95%CI 3.2 至 4.1）和 0.5（95%CI 0.4 至 0.6）；70 岁及以上的毛利人、太平洋岛民和亚洲人发病率比分别为 1.5（95%CI 1.4 至 1.6）、1.5（95%CI 1.3 至 1.7）和 0.5（95%CI 0.5 至 0.6）。2006 年至 2018 年间，70 岁及以上患者的族裔特异性发病率因欧洲/其他族裔（APC-2.0%，95%CI-2.5%至-1.6%）和亚洲人（APC-3.3%，95%CI-4.4%至-2.1%）的下降而出现差异，但毛利人和太平洋岛民的发病率保持不变。相比之下，在<70 岁的患者中，无论族裔如何，发病率都有所增加或保持不变。
在过去的 13 年中，新西兰因 HF 住院的族裔不平等现象有所扩大。需要采取紧急行动，解决导致毛利人和太平洋岛民 HF 发生的诱发因素。
