非裔美国女性和男性的冠心病发病率及生存率。美国国家健康和营养检查调查I流行病学随访研究。

Coronary heart disease incidence and survival in African-American women and men. The NHANES I Epidemiologic Follow-up Study.

作者信息

Gillum R F, Mussolino M E, Madans J H

机构信息

Office of Analysis, Epidemiology, and Health Promotion, Centers for Disease Control and Prevention, Hyattsville, MD 20782, USA.

出版信息

Ann Intern Med. 1997 Jul 15;127(2):111-8. doi: 10.7326/0003-4819-127-2-199707150-00003.

DOI:10.7326/0003-4819-127-2-199707150-00003

PMID:9229999

Abstract

BACKGROUND

Relatively few data are available on risk for or survival with coronary heart disease in African-American persons.

OBJECTIVE

To determine whether incidence of coronary heart disease, rate of survival with the disease, and rate of coronary surgery differ between ethnic groups.

DESIGN

Prospective cohort study.

SETTING

United States.

PARTICIPANTS

Persons who responded to the National Health and Nutrition Examination Survey (NHANES) I Epidemiologic Follow-up Study. Included in this analysis were 11406 white persons and African-American persons aged 25 to 74 years who had no history of coronary heart disease. Average follow-up for survivors was 19 years (maximum, 22 years).

MEASUREMENTS

Incident coronary heart disease.

RESULTS

Compared with that in white persons, the age-adjusted risk for coronary heart disease was higher in African-American women aged 25 to 54 years (relative risk, 1.76 [95% CI, 1.36 to 2.29]) but was lower in African-American men within each age subgroup. The age-adjusted risk was lower in African-American men for all ages combined (25 to 74 years) (relative risk, 0.78 [CI, 0.65 to 0.93] for coronary heart disease and 0.62 [CI, 0.42 to 0.92] for acute myocardial infarction). The higher rate in African-American women aged 25 to 54 years could be explained statistically by the higher risk factor levels in these women. Ethnic groups did not significantly differ in survival after the first hospitalization for coronary heart disease. However, the incidence of coronary procedures after hospitalization for coronary heart disease was markedly lower in African-American persons than in white persons (age- and sex-adjusted relative risk, 0.40 [CI, 0.16 to 0.99]).

CONCLUSIONS

Total incidence of coronary heart disease is higher in African-American women aged 25 to 54 years than in white women of the same ages and is lower in African-American men aged 25 to 74 years than in white men of the same ages.

摘要

背景

关于非裔美国人冠心病风险或存活率的数据相对较少。

目的

确定不同种族之间冠心病发病率、疾病存活率以及冠状动脉手术率是否存在差异。

设计

前瞻性队列研究。

地点

美国。

参与者

对国家健康和营养检查调查（NHANES）I流行病学随访研究做出回应的人。该分析纳入了11406名25至74岁且无冠心病病史的白人和非裔美国人。幸存者的平均随访时间为19年（最长22年）。

测量指标

冠心病发病情况。

结果

与白人相比，25至54岁的非裔美国女性经年龄调整后的冠心病风险更高（相对风险，1.76[95%CI，1.36至2.29]），但在每个年龄亚组的非裔美国男性中该风险较低。所有年龄（25至74岁）合并计算时，非裔美国男性经年龄调整后的风险较低（冠心病相对风险，0.78[CI，0.65至0.93]；急性心肌梗死相对风险，0.62[CI，0.42至0.92]）。25至54岁非裔美国女性中较高的发病率在统计学上可由这些女性较高的风险因素水平来解释。不同种族在首次因冠心病住院后的存活率上无显著差异。然而，非裔美国人在因冠心病住院后的冠状动脉手术发生率明显低于白人（年龄和性别调整后的相对风险，0.40[CI，0.16至0.99]）。