Vulnerabilities to Health Disparities and Statin Use in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study
Vulnerabilities to Health Disparities and Statin Use in the REGARDS (Reasons for Geographic and Racial Differences in Stroke) Study
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DOI：
10.1161/jaha.116.005449
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发表时间：
2017-09-01
影响因子：
5.4
通讯作者：
Safford, Monika M.
中科院分区：
文献类型：
--
作者：
Schroff, Praful;Gamboa, Christopher M.;Safford, Monika M.
背景——他汀类药物在某些脆弱人群中可能没有得到充分利用，但对一个人的累积脆弱性的影响尚未得到很好的描述。在控制了已知影响卫生服务利用的因素后，我们试图确定个体接受他汀类药物治疗的可能性越来越大。方法和结果 - 我们从 REGARDS（中风的地理和种族差异的原因）研究中确定了 18 216 名参与者，这些参与者有他汀类药物适应症或正在服用他汀类药物，经药瓶审查验证。他汀类药物的使用情况根据 5 个主要脆弱领域单独和组合进行评估：老年、黑人种族、女性、高地区贫困和缺乏健康保险。该研究包括 5286 名白人男性、4180 名黑人男性、2791 名白人女性和 4194 名黑人女性； 5.6%的样本没有漏洞，20.6%的样本有1个漏洞，29.2%的样本有2个漏洞，27.3%的样本有3个漏洞，17.3%的样本有4或5个漏洞。所有种族性别群体使用他汀类药物的可能性均低于白人；与白人男性相比，黑人女性的使用流行率为 0.80（P
Background-Statins may be underutilized in certain vulnerable populations, but the effect of cumulative vulnerabilities within 1 individual is not well described. We sought to determine the likelihood of receiving statins with an increasing number of vulnerabilities in an individual, after controlling for factors known to influence health services utilization.Methods and Results-We identified 18 216 participants from the REGARDS (Reasons for Geographic and Racial Differences in Stroke) study who had a statin indication or who were taking statins, as verified by pill bottle review. Statin use was assessed with respect to 5 major vulnerability domains alone and in combination: older age, black race, female sex, high area-level poverty, and lack of health insurance. The study included 5286 white men, 4180 black men, 2791 white women, and 4194 black women; 5.6% of the sample had no vulnerabilities, 20.6% had 1 vulnerability, 29.2% had 2 vulnerabilities, 27.3% had 3 vulnerabilities, and 17.3% had 4 or 5 vulnerabilities. All race-sex groups were less likely than white men to use statins; prevalence of use was 0.80 in black women with reference to white men (P