Cardiovascular Disease among Asians and Pacific Islanders (CASPER)

 简介(申请人提供)：心血管疾病(CVD)是美国主要的死亡原因，2008年的总成本(包括高血压)接近3000亿美元。脑血管病的进展是多年的，受到一系列人口、临床和心理社会因素的影响，这些因素在不同的人群中有所不同。在美国，亚洲人和太平洋岛民对这些因素知之甚少。亚洲人现在是美国增长最快的少数族裔人口，在过去十年中增长了43%，从1020万增加到1470万。7同样，夏威夷土著和其他太平洋岛民人口在同一时期增长了35%以上。虽然美国的亚裔人口通常被认为比其他少数族裔和非西班牙裔白人更健康，但新的研究表明，一些亚裔群体和太平洋岛民患心血管疾病和相关不良结局的风险可能更高。随着人口的增长，这些人口的健康状况将对美国未来的公共卫生保健需求和成本产生越来越大的影响。这一令人信服的关于原料药人群的心血管疾病知识差距促使美国心脏协会和国家肺、心脏和血液研究所呼吁进行研究，以提高原料药人群对心血管疾病的了解。10为了填补关于原料药人群健康差距的这一重要知识空白，我们将测量9个明确定义的原料药人群中的心血管疾病患病率和结果，并全面评估人口、临床和心理社会因素在解释这些群体之间观察到的心血管疾病患病率和结果差异中的作用。多学科研究团队在流行病学、心血管疾病以及社会和心理因素在健康差距中的作用方面提供了广泛的专业知识。研究人群将来自位于不同地理区域的两个大型综合医疗保健系统的成员，其中有大量亚洲和太平洋岛民聚集地(夏威夷和加利福尼亚州北部)。这项研究将利用两个健康计划的电子健康记录(EHR)系统中包含的十多年临床数据的丰富细节。我们还将通过对1万人的大规模调查来收集患者报告的数据。这项研究的目的是：1.描述亚洲、太平洋岛民和混血API亚群中心血管疾病患病率的差异；2.确定人口、临床和心理社会因素是否可以解释这些人群中观察到的心血管疾病患病率的差异；3.描述这些人群中心血管疾病结局的差异，包括生活质量，并确定人口、临床和心理社会因素是否可以解释观察到的差异。研究结果将为美国快速增长的多样化人口中与心血管疾病患病率和预后相关的潜在因素提供重要的新证据。这些信息将为在多个层面-提供者、患者和卫生系统-进行有针对性的干预提供战略指导，以降低心血管疾病的死亡率和发病率。

 DESCRIPTION (provided by applicant): Cardiovascular disease (CVD) is the leading cause of death in the US, with total costs (including hypertension) of nearly $300 billion in 2008. The progression of CVD occurs over many years and is influenced by a series of demographic, clinical and psychosocial factors that vary across populations. In the US, these factors are least well understood among Asians and Pacific Islanders. Asians are now the fastest-growing minority population in the United States, increasing 43% from 10.2 million to 14.7 million in the past decade.7 Similarly, Native Hawaiian and other Pacific Islander populations have increased by more than 35% during this same time. While Asian populations in the U.S. are commonly thought to be healthier than other minority groups and non-Hispanic Whites, emerging research suggests that some Asian subgroups and Pacific Islanders might be at higher risk for CVD and associated poor outcomes. With such population growth, the health of these populations will have an increasing impact upon future US public health care needs and costs. This compelling CVD knowledge gap about API populations has prompted the American Heart Association and the National Lung, Heart and Blood Institute to call for research that will improve the understanding of CVD among API subpopulations.10 To fill this important gap in knowledge about health disparities among API, we will measure CVD prevalence and outcomes among 9 well-defined API populations, and comprehensively assess the role of demographic, clinical and psychosocial factors in explaining observed differences in CVD prevalence and outcomes among these groups. The multidisciplinary study team brings broad expertise in epidemiology, cardiovascular disease, and the role of social and psychological factors in health disparities. The study population will be drawn from the membership of two large, integrated health care systems located in different geographic regions with large clusters of Asian and Pacific Islander residents (Hawaii and northern California). The study will leverage the rich detail of more than a decade of clinical data contained within electronic health records (EHR) systems of both health plans. We will also collect patient reported data via a large-scale survey of 10,000 people. The study aims are to: 1. Describe differences in the prevalence of CVD among Asian, Pacific Islander, and mixed-race API subpopulations; 2. Determine whether demographic, clinical and psychosocial factors explain observed differences in CVD prevalence among these populations; and 3. Describe differences in CVD outcomes among these populations, including quality of life, and determine whether demographic, clinical and psychosocial factors explain observed differences. Study results will provide important new evidence about underlying factors associated with CVD prevalence and outcomes among rapidly growing, diverse populations in the U.S. This information will provide strategic guidance for targeted interventions at multiple levels-provider, patient, and health system-to reduce CVD mortality and morbidity.