Cardiovascular disease mortality in Hispanics and non-Hispanic Whites
Cardiovascular disease mortality in Hispanics and non-Hispanic Whites
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DOI：
10.1093/aje/kwf140
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发表时间：
2002-11-15
影响因子：
5
通讯作者：
Hamman, RF
中科院分区：
文献类型：
--
作者：
Swenson, CJ;Trepka, MJ;Hamman, RF
尽管有更差的心血管疾病（CVD）风险状况，但在基于死亡证明的研究中，西班牙裔的CVD死亡率低于非西班牙裔白人。这项研究检查了1984年至1998年期间发生的310例死亡，其中有1,862名西班牙裔和非西班牙裔白色参与者参加了圣路易斯谷糖尿病研究，使用医疗记录对死亡原因进行分类。在无糖尿病的人群中，非西班牙裔白人的年龄调整全因死亡率为6.1/1000人年，西班牙裔为7.4/1000人年。在糖尿病患者中，非西班牙裔白人为24.3/1000人年，西班牙裔为21.9/1000人年。在非糖尿病患者中，年龄调整的CVD死亡率在非西班牙裔白人中为2.5/1000人年，在西班牙裔中为1.6/1000人年。在糖尿病患者中，非西班牙裔白人为12.9/1000人年，西班牙裔为8.8/1000人年。在非糖尿病患者中，西班牙裔与非西班牙裔白人相比，CVD死亡的校正风险比为0.65（95%置信区间（CI）：0.34，1.23）。冠心病死亡的风险比为0.95（95% CI：0.35，2.59）。在糖尿病患者中，校正常规和糖尿病危险因素后，CVD死亡的风险比为0.44（95% CI：0.26，0.74），冠心病死亡的风险比为0.43（95% CI：0.21，0.91）。仅在患有糖尿病的西班牙裔男性中观察到CVD死亡风险的统计学显著降低。竞争性死亡率或与糖尿病相互作用的因素可以解释这些差异。
Despite a worse cardiovascular disease (CVD) risk profile, Hispanics have lower CVD mortality than non-Hispanic Whites in studies based on death certificates. This study examined 310 deaths that occurred between 1984 and 1998 among 1,862 Hispanic and non-Hispanic White participants in the San Luis Valley Diabetes Study, using medical records to classify cause of death. Among persons without diabetes, the age-adjusted all-cause mortality rate was 6.1/1,000 person-years in non-Hispanic Whites and 7.4/1,000 person-years in Hispanics. Among persons with diabetes, it was 24.3/1,000 person-years in non-Hispanic Whites and 21.9/1,000 person-years in Hispanics. Among nondiabetics, the age-adjusted CVD mortality rate was 2.5/1,000 person-years in non-Hispanic Whites and 1.6/1,000 person-years in Hispanics. Among diabetics, it was 12.9/1,000 person-years in non-Hispanic Whites and 8.8/1,000 person-years in Hispanics. Among nondiabetics, the adjusted hazard ratio for CVD death in Hispanics compared with non-Hispanic Whites was 0.65 (95% confidence interval (CI): 0.34,1.23). The hazard ratio for coronary heart disease death was 0.95 (95% CI: 0.35, 2.59). Among diabetics, the hazard ratio for CVD death, after adjustment for conventional and diabetes risk factors, was 0.44 (95% CI: 0.26, 0.74), and for coronary heart disease death it was 0.43 (95% CI: 0.21, 0.91). A statistically significant decreased risk of CVD death was observed only in male Hispanics with diabetes. Competing mortality or factors that interact with diabetes may explain these differences.