Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis.
Differences in the incidence of congestive heart failure by ethnicity: the multi-ethnic study of atherosclerosis.
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DOI：
10.1001/archinte.168.19.2138
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发表时间：
2008-10-27
影响因子：
--
通讯作者：
Lima, Joao A. C.
中科院分区：
文献类型：
--
作者：
Bahrarni, Hossein;Kronmal, Richard;Bluemke, David A.;Olson, Jean;Shea, Steven;Liu, Kiang;Burke, Gregory L.;Lima, Joao A. C.
在一项多种族、基于人群的研究中，尚未证明充血性心力衰竭（CHF）事件与种族之间的关系以及导致CHF机制的种族/种族差异。我们的目的是评价人种/种族与CHF事件之间的关系。动脉粥样硬化多种族研究（梅萨）是一项队列研究，包括4个种族的6814名受试者：白色（38.5%）、非洲裔美国人（27.8%）、西班牙裔美国人（21.9%）和华裔美国人（11.8%）。基线时有心血管疾病史的参与者被排除在外。采用考克斯比例风险模型进行数据分析。在中位随访4.0年期间，79名参与者发生CHF（发生率：3.1/1000人-年）。非裔美国人的CHF发生率最高，其次是西班牙裔、白色和华裔美国人受试者（发生率分别为：4.6、3.5、2.4和1.0/1000人-年）。尽管非裔美国人发生CHF的风险高于白色受试者（风险比，1.8; 95%置信区间，1.1-3.1），但将高血压和/或糖尿病纳入包括种族的模型中消除了CHF事件的统计学种族差异。此外，与其他种族相比，非裔美国人发生CHF的比例最高（75%），而不是临床心肌梗死（P = 0.06）。非裔美国人中CHF事件的高风险与高血压和糖尿病的患病率以及社会经济地位的差异有关。CHF的机制也因种族而异;非裔美国人中的中期心肌梗死影响最小，西班牙裔和白色参与者中左心室质量增加的影响最大。
The relationship between incident congestive heart failure (CHF) and ethnicity as well as racial/ethnic differences in the mechanisms leading to CHF have not been demonstrated in a multiracial, population-based study. Our objective was to evaluate the relationship between race/ethnicity and incident CHF. The Multi-Ethnic Study of Atherosclerosis (MESA) is a cohort study of 6814 participants of 4 ethnicities: white (38.5%), African American (27.8%), Hispanic (21.9%), and Chinese American (11.8%). Participants with a history of cardiovascular disease at baseline were excluded. Cox proportional hazards models were used for data analysis. During a median follow-up of 4.0 years, 79 participants developed CHF (incidence rate: 3.1 per 1000 person-years). African Americans had the highest incidence rate of CHF, followed by Hispanic, white, and Chinese American participants (incidence rates: 4.6, 3.5, 2.4, and 1.0 per 1000 person-years, respectively). Although risk of developing CHF was higher among African American compared with white participants (hazard ratio, 1.8; 95% confidence interval, 1.1-3.1), adding hypertension and/or diabetes mellitus to models including ethnicity eliminated statistical ethnic differences in incident CHF. Moreover, African Americans had the highest proportion of incident CHF not preceded by clinical myocardial infarction (75%) compared with other ethnic groups (P = .06). The higher risk of incident CHF among African Americans was related to differences in the prevalence of hypertension and diabetes mellitus as well as socioeconomic status. The mechanisms of CHF also differed by ethnicity; interim myocardial infarction had the least influence among African Americans, and left ventricular mass increase had the greatest effect among Hispanic and white participants.
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