MORTALITY-RATES AND RISK-FACTORS FOR CORONARY-DISEASE IN BLACK AS COMPARED WITH WHITE MEN AND WOMEN
MORTALITY-RATES AND RISK-FACTORS FOR CORONARY-DISEASE IN BLACK AS COMPARED WITH WHITE MEN AND WOMEN
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DOI：
10.1056/nejm199307083290201
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发表时间：
1993-07-08
影响因子：
158.5
通讯作者：
TYROLER, HA
中科院分区：
文献类型：
--
作者：
KEIL, JE;SUTHERLAND, SE;TYROLER, HA
背景。目前公认的冠状动脉疾病的危险因素主要是从白人人群的调查中确定的。在这项调查中，我们估计了冠状动脉疾病和任何原因的死亡率，并确定了白人和黑人冠状动脉疾病死亡的危险因素。在查尔斯顿心脏研究中收集了30年的数据，用于估计死亡率，并量化1960年和1961年基线检查中653名白人男性、333名黑人男性、741名白人女性和454名黑人女性的风险因素。冠状动脉疾病死亡率的比率没有显著的种族差异；然而，妇女的死亡率明显低于男子。在30年期间，白人男性每1000人年的冠心病死亡率为5.2(95%可信区间，4.1 - 6.3)，黑人男性为4.6(3.0 - 6.2)，白人女性为2:1(1.6 - 2.6)，黑人女性为3.2（2.3 - 4.0）。四组患者的收缩压是冠状动脉疾病死亡率的显著或接近显著的预测因子；白人男性、白人女性和黑人女性的血清胆固醇水平；以及白人男性、白人女性和黑人男性吸烟。虽然差异没有统计学意义，但四组糖尿病患者死于冠状动脉疾病的风险持续增加。在白人男性和黑人女性中，较高的教育水平预示着较低的冠心病死亡率。所有死因加在一起，黑人的死亡率高于白人。在所有四组中，高血压、吸烟史和糖尿病史的存在是任何原因导致死亡的显著或接近显著的预测因素。虽然黑人男性的冠心病死亡率比白人男性低，黑人女性的冠心病死亡率比白人女性高，但在查尔斯顿心脏研究的30年随访中，黑人和白人的死亡率比没有统计学意义，冠心病死亡的主要危险因素在黑人和白人中相似。
Background. Currently recognized risk factors for coronary artery disease have been identified primarily from investigations of white populations. In this investigation, we estimated mortality rates for coronary disease and for any cause and identified risk factors for death from coronary disease among whites and blacks.Methods. Data collected over a 30-year period in the Charleston Heart Study were used to estimate mortality rates and quantify associations with risk factors assessed at the base-line examination in 1960 and 1961 of 653 white men, 333 black men, 741 white women, and 454 black women.Results. There were no significant racial differences in the rate ratios for death from coronary disease; however, women had significantly lower death rates than men. Over the 30-year period, the mortality rates for coronary disease per 1000 person-years were 5.2 for white men (95 percent confidence interval, 4.1 to 6.3), 4.6 for black men (3.0 to 6.2), 2:1 for white women (1.6 to 2.6), and 3.2 for black women (2.3 to 4.0). Significant, or nearly significant, predictors of mortality due to coronary disease were systolic blood pressure in all four groups; serum cholesterol level among white men, white women, and black women; and smoking among white men, white women, and black men. Although the difference was not statistically significant, the risk of death from coronary disease was consistently increased among diabetics in all four groups. A higher level of education was predictive of lower rates of death due to coronary disease among white men and black women. For all causes of death taken together, the rates for blacks were higher than the rates for whites. The presence of hypertension, a history of smoking, and a history of diabetes were significant or nearly significant predictors of mortality from any cause in all four groups.Conclusions. Although the rates of death from coronary disease were somewhat lower among black men than white men and higher among black women than white women, the black:white mortality rate ratios were not statistically significant, and the major risk factors for mortality from coronary disease were similar in blacks and whites in the 30-year follow-up of the Charleston Heart Study.