DOES RACIAL VARIATION IN RISK-FACTORS EXPLAIN BLACK-WHITE DIFFERENCES IN THE INCIDENCE OF HYPERTENSIVE END-STAGE RENAL-DISEASE
DOES RACIAL VARIATION IN RISK-FACTORS EXPLAIN BLACK-WHITE DIFFERENCES IN THE INCIDENCE OF HYPERTENSIVE END-STAGE RENAL-DISEASE
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DOI：
10.1001/archinte.151.7.1359
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发表时间：
1991-07-01
影响因子：
--
通讯作者：
KLAG, MJ
中科院分区：
文献类型：
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作者：
WHITTLE, JC;WHELTON, PK;KLAG, MJ
分析前瞻性收集的高血压终末期肾病（HT-ESRD）治疗发生率数据，以探讨黑人HT-ESRD发生率高于白人是否由于ESRD推定危险因素的差异。在马里兰区域ESRD登记处（网络31）集水区，黑人与白人相比，男性和女性的总体年龄调整后的HT-ESRD相对风险分别为7.4（95%可信区间，5.9至9.4）和9.9（95%可信区间，7.4至13.1）。在人群水平分析中，网络31中13个地区的黑人和白人人群的种族特异性HT-ESRD发病率与这些人群中假定的ESRD危险因素的患病率有关。后者是根据1981-1982年马里兰州家庭高血压调查估计的。黑人人群的未调整HT-ESRD发病率比白人人群高5.6倍（95%置信区间，3.9 - 8.1）。人群中HT-ESRD的发病率也与该人群的高血压、重度高血压和糖尿病患病率直接相关，与社会经济地位和高血压诊断时的平均年龄呈负相关。当同时调整年龄、高血压患病率、严重高血压、糖尿病和教育水平时，黑人HT-ESRD的风险仍然是白人的4.5倍（95%置信区间，3.2 - 6.2）。我们的研究结果不能支持这样的假设，即高血压患病率、严重程度、发病年龄、糖尿病患病率或社会经济地位的种族相关差异，可以解释公认的HT-ESRD发病率的黑人-白人差异。
Prospectively collected data on the incidence of treated hypertensive end-stage renal disease (HT-ESRD) were analyzed to investigate whether the higher rate of HT-ESRD in blacks compared with whites is due to differences in putative ESRD risk factors. The overall age-adjusted relative risks of HT-ESRD for black compared with white residents in the Maryland Regional ESRD Registry (Network 31) Catchment Area were 7.4 (95% confidence interval, 5.9 to 9.4) and 9.9 (95% confidence Interval, 7.4 to 13.1) for men and women, respectively. In a population level analysis, race-specific HT-ESRD incidence rates in the black and white populations of 13 regions in Network 31 were related to the prevalence of putative ESRD risk factors in those populations. The latter were estimated from the 1981-1982 Maryland Statewide Household Hypertension Survey. Black populations had a 5.6-fold (95% confidence interval, 3.9 to 8.1) higher unadjusted incidence of HT-ESRD than white populations. The HT-ESRD incidence in a population was also directly related to that population's prevalence of hypertension, severe hypertension, and diabetes mellitus and inversely related to measures of socioeconomic status and mean age at diagnosis of hypertension. When adjusted simultaneously for age, prevalence of hypertension, severe hypertension, diabetes, and level of education, the risk of HT-ESRD was still 4.5 (95% confidence interval, 3.2 to 6.2) times higher for black compared with white populations. Our findings failed to support the hypothesis that race-related differences in the prevalence, severity, or age at onset of hypertension, in the prevalence of diabetes or in socioeconomic status, explain the well-recognized black-white differences in the HT-ESRD incidence.