Cardiovascular Health in African Americans A Scientific Statement From the American Heart Association
Cardiovascular Health in African Americans A Scientific Statement From the American Heart Association
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DOI：
10.1161/cir.0000000000000534
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发表时间：
2017-11-21
期刊：
影响因子：
37.8
通讯作者：
Yancy, Clyde W.
中科院分区：
文献类型：
--
作者：
Carnethon, Mercedes R.;Pu, Jia;Yancy, Clyde W.
背景和目的：心血管疾病发病率和死亡率在全人口范围内的下降并没有被非洲裔美国人平等地分享。非裔美国人社区的心血管疾病负担仍然很高，是非裔美国人和白人之间预期寿命差异的主要原因。本科学声明的目的是描述非裔美国人的心血管健康状况，并强调疾病预防和管理的独特考虑因素。方法：主要信息来源是通过PubMed/Medline和疾病控制和预防中心的在线来源确定的。传统心血管危险因素的高患病率（如高血压、糖尿病、肥胖和动脉粥样硬化性心血管疾病风险）是非裔美国人心血管疾病发病年龄相对较早的基础。特别是高血压在非裔美国人中非常普遍，并直接导致非裔美国人在中风、心力衰竭和外周动脉疾病方面的显著差异。尽管有针对非裔美国人的有效药物治疗和适应症（如心力衰竭药物），但非裔美国人的疾病管理效果较差，死亡率较高。这些在心血管疾病的持续差异的解释是多因素的，从个人层面的社会environment.CONCLUSIONS跨度：战略需要促进非裔美国人的心血管健康的公平性，需要从一个广泛的利益相关者，包括临床医生和研究人员跨多个学科的投入。
BACKGROUND AND PURPOSE: Population-wide reductions in cardiovascular disease incidence and mortality have not been shared equally by African Americans. The burden of cardiovascular disease in the African American community remains high and is a primary cause of disparities in life expectancy between African Americans and whites. The objectives of the present scientific statement are to describe cardiovascular health in African Americans and to highlight unique considerations for disease prevention and management.METHOD: The primary sources of information were identified with PubMed/Medline and online sources from the Centers for Disease Control and Prevention.RESULTS: The higher prevalence of traditional cardiovascular risk factors (eg, hypertension, diabetes mellitus, obesity, and atherosclerotic cardiovascular risk) underlies the relatively earlier age of onset of cardiovascular diseases among African Americans. Hypertension in particular is highly prevalent among African Americans and contributes directly to the notable disparities in stroke, heart failure, and peripheral artery disease among African Americans. Despite the availability of effective pharmacotherapies and indications for some tailored pharmacotherapies for African Americans (eg, heart failure medications), disease management is less effective among African Americans, yielding higher mortality. Explanations for these persistent disparities in cardiovascular disease are multifactorial and span from the individual level to the social environment.CONCLUSIONS: The strategies needed to promote equity in the cardiovascular health of African Americans require input from a broad set of stakeholders, including clinicians and researchers from across multiple disciplines.