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心血管疾病一级预防中的种族和民族差异。

Racial and Ethnic Disparities in Primary Prevention of Cardiovascular Disease.

机构信息

Department of Cardiovascular Sciences, University of Leicester, Leicester, United Kingdom; National Institute for Health Research (NIHR) Leicester Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, United Kingdom; Diabetes Research Centre, University of Leicester, Leicester, United Kingdom.

Royal Free Hospital, London, United Kingdom.

出版信息

Can J Cardiol. 2024 Jun;40(6):1016-1030. doi: 10.1016/j.cjca.2024.01.028. Epub 2024 Feb 2.

Abstract

Cardiovascular disease (CVD) disproportionately affects ethnic-minority groups globally. Ethnic-minority groups face particularly high CVD burden and mortality, exacerbated by disparities across modifiable risk factors, wider determinants of health, and limited access to preventative interventions. This narrative review summarizes evidence on modifiable risk factors, such as physical activity, hypertension, diet, smoking, alcohol consumption, diabetes, and the polypill for the primary prevention of CVD in ethnic minorities. Across these factors, we find inequities in risk factor prevalence. The evidence underscores that inequalities in accessibility to interventions and treatments impede progress in reducing CVD risk using primary prevention interventions for ethnic-minority people. Although culturally tailored interventions show promise, further research is required across the different risk factors. Social determinants of health and structural inequities also exacerbate CVD risk for ethnic-minority people and warrant greater attention. Additionally, we find that only limited ethnicity-specific data and guidelines are available on CVD primary prevention interventions for most risk factors. To address these gaps in research, we provide recommendations that include the following: investigating the sustainability and real-world effectiveness of culturally sensitive interventions; ensuring that ethnic-minority peoples' perspectives are considered in research; longitudinal tracking of risk factors; interventions and outcomes in ethnic-minority people; and ensuring that data collection and reporting of ethnicity data are standardized.

摘要

心血管疾病(CVD)在全球范围内不成比例地影响着少数民族群体。少数民族群体面临着特别高的 CVD 负担和死亡率,这些问题因可改变的风险因素、更广泛的健康决定因素以及获得预防干预措施的机会有限而加剧。本叙述性评论总结了关于可改变的风险因素的证据,例如体力活动、高血压、饮食、吸烟、饮酒、糖尿病和多效药丸,用于少数民族人群的 CVD 一级预防。在这些因素中,我们发现风险因素的流行存在不平等现象。证据表明,干预措施和治疗方法的获取不平等阻碍了使用一级预防干预措施来降低少数民族人群的 CVD 风险的进展。尽管针对文化的干预措施显示出了希望,但在不同的风险因素方面仍需要进一步的研究。健康的社会决定因素和结构性不平等也加剧了少数民族人群的 CVD 风险,值得更多关注。此外,我们发现,对于大多数风险因素,关于 CVD 一级预防干预措施的,只有有限的特定于族裔的数据和指南。为了解决这些研究差距,我们提供了以下建议:研究具有文化敏感性的干预措施的可持续性和实际效果;确保在研究中考虑少数民族人群的观点;对少数民族人群中的风险因素、干预措施和结果进行纵向跟踪;并确保标准化数据收集和族裔数据报告。

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