Statin and Aspirin Use Among Hispanic and Latino Adults at High Cardiovascular Risk: Findings From the Hispanic Community Health Study/Study of Latinos.
Statin and Aspirin Use Among Hispanic and Latino Adults at High Cardiovascular Risk: Findings From the Hispanic Community Health Study/Study of Latinos.
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DOI：
10.1161/jaha.115.002905
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发表时间：
2016-03-30
影响因子：
5.4
通讯作者：
Daviglus ML
中科院分区：
文献类型：
--
作者：
Qato DM;Lee TA;Durazo-Arvizu R;Wu D;Wilder J;Reina SA;Cai J;Gonzalez F 2nd;Talavera GA;Ostfeld RJ;Daviglus ML
尽管不同背景的美国西班牙裔/拉丁裔成年人的心血管疾病患病率和相关风险因素存在差异，但关于心血管疾病一级和二级预防药物使用是否存在差异的信息很少。我们研究了心血管高危的美国西班牙裔/拉丁裔成年人中他汀类药物和阿司匹林的使用率。一项基于人群的多中心研究，西班牙裔社区健康研究/拉丁美洲人研究，共纳入了16415名墨西哥、波多黎各、古巴、多米尼加、南美和中美洲背景的受试者，年龄在18至74岁之间，于2008年3月至2011年6月入组。我们的分析仅限于4139名被认为具有高心血管风险的参与者。总体而言，他汀类药物和阿司匹林使用的年龄调整患病率分别为25%和44%，但在心血管高危人群中，不同西班牙裔/拉丁裔背景的患病率不同;他汀类药物使用显著高于与其他背景的成年人相比，波多黎各（33%）和多米尼加（28%）背景的成年人（P<0.001）（墨西哥，24%;古巴，22%;中美洲，20%;南美洲，22%）。阿司匹林的使用没有差异。在调整健康保险覆盖范围后，具有波多黎各背景的参与者中他汀类药物使用率的差异显著降低，比值比为1.73（95% CI 1.30-2.31）至1.30（95% CI 0.97-1.75），多米尼加背景，比值比为1.45（95% CI 1.04-2.02）至1.07（95% CI 0.75-1.52）。在不同背景的西班牙裔/拉丁裔成年人中，他汀类药物的使用在具有心血管高风险的波多黎各和多米尼加背景的成年人中更为普遍。他汀类药物使用的这些差异部分是由保险覆盖范围的差异解释的。这些发现对于预防不断增长的美国西班牙裔/拉丁裔人群中心血管结局的差异具有重要意义。
Despite variations in the prevalence of cardiovascular disease and related risk factors among US Hispanic/Latino adults of diverse backgrounds, there is little information on whether disparities exist in the use of medications for the primary and secondary prevention of cardiovascular disease. We examined the prevalence of statin and aspirin use among diverse US Hispanic/Latino adults at high cardiovascular risk. A multicenter population‐based study, the Hispanic Community Health Study/Study Of Latinos, included a total of 16 415 participants of Mexican, Puerto Rican, Cuban, Dominican, South American, and Central American backgrounds who were aged 18 to 74 years and enrolled between March 2008 and June 2011. Our analyses were limited to 4139 participants considered to be at high cardiovascular risk. Age‐adjusted prevalence of statin and aspirin use was 25% and 44%, respectively, overall but varied by Hispanic/Latino background among those at high cardiovascular risk; statin use was significantly higher (P<0.001) among adults of Puerto Rican (33%) and Dominican (28%) backgrounds compared with adults of other backgrounds (Mexican, 24%; Cuban, 22%; Central American, 20%; South American, 22%). There was no difference in aspirin use. After adjusting for health insurance coverage, the difference in prevalence of statin use was substantially reduced among participants with a Puerto Rican background, from an odds ratio of 1.73 (95% CI 1.30–2.31) to 1.30 (95% CI 0.97–1.75), and with a Dominican background, from an odds ratio of 1.45 (95% CI 1.04–2.02) to 1.07 (95% CI 0.75–1.52), in comparison to their counterparts. Among Hispanic/Latino adults of diverse backgrounds, statin use was more prevalent among adults with Puerto Rican and Dominican backgrounds at high cardiovascular risk. These differences in statin use were explained, in part, by differences in insurance coverage. These findings have important implications for the prevention of disparities in cardiovascular outcomes within the growing US Hispanic/Latino population.