高胆固醇血症识别中的种族差异。

Racial differentials in the identification of hypercholesterolemia.

作者信息

Naumburg E H, Franks P, Bell B, Gold M, Engerman J

机构信息

Department of Family Medicine, University of Rochester, New York.

出版信息

J Fam Pract. 1993 Apr;36(4):425-30.

PMID:8463785

Abstract

BACKGROUND

African Americans have higher rates of cardiovascular disease than white Americans. To address this differential, barriers to cardiovascular risk reduction need to be identified. This study examines the association of race with the likelihood of screening for and diagnosis of hypercholesterolemia.

METHODS

Possible associations between demographic variables and screening for and diagnosis of hypercholesterolemia were examined on data gathered in a prospective fashion in an office-based family medicine residency training program in Rochester, New York. A consecutive sample of all patients seen between December 15, 1988, and April 15, 1990, about whom there was complete data collection (age, sex, insurance, race, and other cardiovascular risk factors) were included in the multivariate analyses (N = 4256).

RESULTS

After controlling for age, sex, insurance status, socioeconomic status, number of visits, and other cardiovascular risk factors, it was found that minorities were less likely to have been screened for cholesterol levels than whites (adjusted odds ratio [AOR] = 0.84, 95% confidence interval [CI] = 0.98 to 0.72). The mean cholesterol level did not differ by race (mean cholesterol for whites, 204 mg/dL [5.28 mmol/L], and for minorities, 203 mg/dL [5.25 mmol/L], t = 0.7, P = .47). Among those screened, minorities were less likely than whites to have been diagnosed with hypercholesterolemia (AOR = 0.62, 95% CI = 0.86 to 0.44; and 0.47 (95% CI = 0.28 to 0.78] in those with a cholesterol level greater than 240 mg/dL [6.2 mmol/L]).

CONCLUSIONS

Our data suggest that provider behavior in diagnosing hypercholesterolemia varies by the race of the patient.

摘要

背景

非裔美国人患心血管疾病的比率高于美国白人。为解决这一差异，需要找出降低心血管疾病风险的障碍。本研究探讨种族与高胆固醇血症筛查及诊断可能性之间的关联。

方法

在纽约罗切斯特一个以办公室为基础的家庭医学住院医师培训项目中，对以前瞻性方式收集的数据进行分析，以研究人口统计学变量与高胆固醇血症筛查及诊断之间可能存在的关联。对1988年12月15日至1990年4月15日期间就诊的所有患者进行连续抽样，纳入多变量分析的患者需有完整的数据收集（年龄、性别、保险、种族及其他心血管疾病风险因素）（N = 4256）。

结果

在对年龄、性别、保险状况、社会经济地位、就诊次数及其他心血管疾病风险因素进行控制后，发现少数族裔接受胆固醇水平筛查的可能性低于白人（调整优势比[AOR] = 0.84，95%置信区间[CI] = 0.98至0.72）。平均胆固醇水平在种族间无差异（白人平均胆固醇水平为204 mg/dL [5.28 mmol/L]，少数族裔为203 mg/dL [5.25 mmol/L]，t = 0.7，P = 0.47）。在接受筛查的人群中（胆固醇水平大于240 mg/dL [6.2 mmol/L]），少数族裔被诊断为高胆固醇血症的可能性低于白人（AOR = 0.62，95% CI = 0.86至0.44；及0.47 [95% CI = 0.28至0.78]）。