Perceived Discrimination and Incident Cardiovascular Events The Multi-Ethnic Study of Atherosclerosis
Perceived Discrimination and Incident Cardiovascular Events The Multi-Ethnic Study of Atherosclerosis
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DOI：
10.1093/aje/kwv035
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发表时间：
2015-08-01
影响因子：
5
通讯作者：
Roux, Ana V. Diez
中科院分区：
文献类型：
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作者：
Everson-Rose, Susan A.;Lutsey, Pamela L.;Roux, Ana V. Diez
感知歧视与心血管疾病（CVD）危险因素呈正相关；其与CVD的关系尚不清楚。使用来自多民族动脉粥样硬化研究的数据，这是一项基于人群的多民族队列研究，共有6508名年龄在45-84岁之间的成年人，他们最初没有临床CVD，我们检查了与CVD事件相关的终身歧视（在6个生活领域遭受不公平待遇的经历）和日常歧视（感知不公平待遇的日常发生频率）。在平均10.1年的随访期间（2000-2011年），共发生604起事件。在调整了种族/民族、社会人口因素、行为和传统心血管疾病危险因素(风险比（HR) = 1.36, 95%可信区间（CI）： 1.09, 1.70）和控制了慢性应激和抑郁症状（HR = 1.28, 95% CI: 1.01, 1.60）后，报告在>= 2域中存在终生歧视的人（与无歧视的人相比）心血管疾病风险增加。报告的1个域的歧视与CVD无关（HR = 1.05, 95% CI: 0.86, 1.30）。没有种族/民族、年龄或性别的差异。相反，日常歧视与性别相互作用（P = 0.03）。分层模型显示，只有男性的风险增加（评分每增加1个标准差，调整后HR = 1.14, 95% CI: 1.03, 1.27）；控制慢性压力和抑郁症状稍微降低了这种关联（HR = 1.11, 95% CI: 0.99, 1.25）。这项研究表明，在中老年人中，感知到的歧视与心血管疾病风险呈负相关。
Perceived discrimination is positively related to cardiovascular disease (CVD) risk factors; its relationship with incident CVD is unknown. Using data from the Multi-Ethnic Study of Atherosclerosis, a population-based multiethnic cohort study of 6,508 adults aged 45-84 years who were initially free of clinical CVD, we examined lifetime discrimination (experiences of unfair treatment in 6 life domains) and everyday discrimination (frequency of day-to-day occurrences of perceived unfair treatment) in relation to incident CVD. During a median 10.1 years of follow-up (2000-2011), 604 incident events occurred. Persons reporting lifetime discrimination in >= 2 domains (versus none) had increased CVD risk, after adjustment for race/ethnicity and sociodemographic factors, behaviors, and traditional CVD risk factors (hazard ratio (HR) = 1.36, 95% confidence interval (CI): 1.09, 1.70) and after control for chronic stress and depressive symptoms (HR = 1.28, 95% CI: 1.01, 1.60). Reported discrimination in 1 domain was unrelated to CVD (HR = 1.05, 95% CI: 0.86, 1.30). There were no differences by race/ethnicity, age, or sex. In contrast, everyday discrimination interacted with sex (P = 0.03). Stratified models showed increased risk only among men (for each 1-standard deviation increase in score, adjusted HR = 1.14, 95% CI: 1.03, 1.27); controlling for chronic stress and depressive symptoms slightly reduced this association (HR = 1.11, 95% CI: 0.99, 1.25). This study suggests that perceived discrimination is adversely related to CVD risk in middle-aged and older adults.