Wei M, Mitchell B D, Haffner S M, Stern M P
Department of Medicine, University of Texas Health Science Center at San Antonio 78284, USA.
Am J Epidemiol. 1996 Dec 1;144(11):1058-65. doi: 10.1093/oxfordjournals.aje.a008878.
Despite high levels of cardiovascular risk factors, Mexican Americans paradoxically have a lower prevalence of cardiovascular disease. A possible explanation is that conventional cardiovascular risk factors have a lesser impact on this ethnic group. In the present study, a 7- to 8-year follow-up of the San Antonio Heart Study cohort was used to estimate total and cardiovascular disease mortality and their association with baseline risk factors. A total of 2,629 Mexican Americans form the basis of this study, and 1,136 non-Hispanic whites from the same cohort served as the comparison group. The age- and sex-adjusted rates for total death and cardiovascular disease death were somewhat higher in Mexican Americans than non-Hispanic whites (rate ratio for total mortality = 1.4, 95% confidence interval 1.0-2.0; and rate ratio for cardiovascular mortality = 1.3, 95% confidence interval 0.7-2.4). After adjustment for sex, age, and socioeconomic status in multivariate analyses, current smoking, diabetes, high cholesterol, and hypertension were positively associated with all-cause mortality and cardiovascular disease mortality in Mexican Americans. Overall, these risk factors accounted for 45% of all-cause mortality and 55% of cardiovascular disease mortality in this ethnic group. In comparison, the risk factors accounted for 46% of all-cause mortality and 46% of cardiovascular disease mortality in non-Hispanic whites. The authors conclude that cigarette smoking, diabetes, high cholesterol, and hypertension are important predictors of both all-cause and cardiovascular disease deaths in Mexican Americans. There was no evidence for a diminished effect of these risk factors in Mexican Americans.
尽管心血管危险因素水平很高，但墨西哥裔美国人患心血管疾病的患病率却较低，这似乎自相矛盾。一种可能的解释是，传统的心血管危险因素对这个种族群体的影响较小。在本研究中，利用圣安东尼奥心脏研究队列进行了7至8年的随访，以估计全因死亡率和心血管疾病死亡率及其与基线危险因素的关联。本研究共纳入了2629名墨西哥裔美国人，同一队列中的1136名非西班牙裔白人作为对照组。墨西哥裔美国人的全因死亡和心血管疾病死亡的年龄和性别调整率略高于非西班牙裔白人（全因死亡率的率比=1.4，95%置信区间1.0-2.0；心血管死亡率的率比=1.3，95%置信区间0.7-2.4）。在多变量分析中对性别、年龄和社会经济地位进行调整后，当前吸烟、糖尿病、高胆固醇和高血压与墨西哥裔美国人的全因死亡率和心血管疾病死亡率呈正相关。总体而言，这些危险因素占该种族群体全因死亡率的45%和心血管疾病死亡率的55%。相比之下，这些危险因素在非西班牙裔白人中占全因死亡率的46%和心血管疾病死亡率的46%。作者得出结论，吸烟、糖尿病、高胆固醇和高血压是墨西哥裔美国人全因死亡和心血管疾病死亡的重要预测因素。没有证据表明这些危险因素在墨西哥裔美国人中的影响减弱。
