Prevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race
Prevalence of Traditional Cardiac Risk Factors and Secondary Prevention Among Patients Hospitalized for Acute Myocardial Infarction (AMI): Variation by Age, Sex, and Race
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DOI：
10.1089/jwh.2012.3962
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发表时间：
2013-08-01
影响因子：
3.5
通讯作者：
Lichtman, Judith H.
中科院分区：
文献类型：
--
作者：
Leifheit-Limson, Erica C.;Spertus, John A.;Lichtman, Judith H.
背景：对急性心肌梗死（AMI）后患者而言，传统心脏危险因素的修正是一个重要目标。老年患者出院时的危险因素患病率和二级预防工作得到了很好的表征;然而，研究仅限于年轻和少数AMI人群，尤其是女性。在一项19个中心的前瞻性研究中，我们对2369例AMI患者的五种心脏危险因素的患病率和累积数量进行了比较（高血压、高胆固醇血症、当前吸烟、糖尿病、肥胖）。我们还比较了出院时这些危险因素的二级预防策略，包括抗高血压或降脂药物处方和预防行为咨询（戒烟，糖尿病管理，饮食/体重管理）。结果：大约93%的患者有≥ 1个危险因素，72%有≥ 2个危险因素，40%有≥ 3个危险因素。在每个年龄性别组中，黑人的多个危险因素的患病率明显高于白人;黑人妇女的危险因素负担在任何亚组中都最大（60%的老年黑人妇女和54%的年轻黑人妇女有≥ 3个危险因素）。戒烟的二级预防工作是不常见的黑人相比，白色患者，和年轻的黑人患者较少开降压和降脂药物相比，年轻的白色patient.Conclusions：多种心脏危险因素是非常普遍的AMI患者，特别是黑人女性。然而，与白人相比，黑人的二级预防工作不太常见，特别是在年轻患者中。我们的研究结果强调了在这些高风险亚组中需要改进风险因素修改工作。
Background: Modification of traditional cardiac risk factors is an important goal for patients after an acute myocardial infarction (AMI). Risk factor prevalence and secondary prevention efforts at discharge are well characterized among older patients; however, research is limited for younger and minority AMI populations, particularly among women.Methods: Among 2369 AMI patients enrolled in a 19-center prospective study, we compared the prevalence and cumulative number of five cardiac risk factors (hypertension, hypercholesterolemia, current smoking, diabetes, obesity) by age, sex, and race. We also compared secondary prevention strategies at discharge for these risk factors, including prescription of antihypertensive or lipid-lowering medications and counseling on preventive behaviors (smoking cessation, diabetes management, diet/weight management).Results: Approximately 93% of patients had >= 1 risk factor, 72% had >= 2 factors, and 40% had >= 3 factors. The prevalence of multiple risk factors was markedly higher for blacks than for whites within each age-sex group; black women had the greatest risk factor burden of any subgroup (60% of older black women and 54% of younger black women had >= 3 risk factors). Secondary prevention efforts for smoking cessation were less common for black compared with white patients, and younger black patients were less often prescribed anti-hypertensive and lipid-lowering medications compared with younger white patients.Conclusions: Multiple cardiac risk factors are highly prevalent in AMI patients, particularly among black women. Secondary prevention efforts, however, are less common for blacks compared to whites, especially among younger patients. Our findings highlight the need for improved risk factor modification efforts in these high-risk subgroups.