Ramírez E A
University of Puerto Rico School of Medicine, Department of Medicine, San Juan 00936.
Bol Asoc Med P R. 1994 Apr-Jun;86(4-6):28-36.
It has been determined that the prevalence and incidence of coronary artery disease has been lower in Puerto Rico than in the United States. In a controlled comparison with a matched cohort of men from Framingham, Mass, Puerto Rican men were found to have lower serum cholesterol and lower systolic blood pressure, to smoke less, to be more active physically, and to be less sensitive to coronary risk factors. Community surveys have shown that there is moderately less hypertension but more diabetes and possibly more obesity in Puerto Rico than in the United States. Hispanic groups in the United States have shown similar characteristics. Possible reasons for the relative protection from coronary artery disease in Puerto Rico include genetic factors, diet, and life-style. Recent epidemiologic data show that, although mortality from coronary disease and stroke has been steadily decreasing in the United States, it is increasing in Puerto Rico. Recent life-style and dietary changes, social stress, increased life expectancy, and a high death rate from diabetes and hypertension may be contributing to this reversal. Stronger efforts to control cardiovascular risk factors and to improve the management of diabetes and hypertension are needed in Puerto Rico.
已确定波多黎各冠状动脉疾病的患病率和发病率低于美国。在与来自马萨诸塞州弗雷明汉的匹配男性队列进行的对照比较中，发现波多黎各男性的血清胆固醇和收缩压较低，吸烟较少，身体更活跃，并且对冠状动脉危险因素的敏感性较低。社区调查显示，与美国相比，波多黎各的高血压患者略少，但糖尿病患者更多，肥胖者可能也更多。美国的西班牙裔群体也表现出类似特征。波多黎各相对免受冠状动脉疾病影响的可能原因包括遗传因素、饮食和生活方式。最近的流行病学数据表明，尽管美国冠心病和中风的死亡率一直在稳步下降，但在波多黎各却在上升。最近生活方式和饮食的变化、社会压力、预期寿命的增加以及糖尿病和高血压导致的高死亡率可能是造成这种逆转的原因。波多黎各需要加大力度控制心血管危险因素，并改善糖尿病和高血压的管理。
