Cardiovascular Disease among Asians and Pacific Islanders (CASPER)

 描述（由申请人提供）：心血管疾病（CVD）是美国的主要死亡原因，2008年总费用（包括高血压）接近3000亿美元。CVD的进展发生在许多年内，并受到一系列人口统计学，临床和心理社会因素的影响，这些因素在人群中各不相同。在美国，亚洲人和太平洋岛民对这些因素的理解最少。亚洲人现在是美国增长最快的少数民族人口，在过去十年中从1020万增加到1470万，增加了43%。虽然美国的亚裔人口通常被认为比其他少数民族和非西班牙裔白人更健康，但新的研究表明，一些亚洲亚群和太平洋岛民可能患心血管疾病和相关不良结局的风险更高。随着人口的增长，这些人群的健康将对未来美国公共卫生保健需求和成本产生越来越大的影响。 关于API人群的这一令人信服的CVD知识缺口促使美国心脏协会和国家肺、心和血液研究所呼吁开展研究，以提高对API亚群中CVD的理解。10为了填补关于API人群健康差异的这一重要知识缺口，我们将测量9个明确定义的API人群中CVD的患病率和结局，并全面评估人口统计学、临床和心理社会因素在解释观察到的差异，心血管疾病的患病率和结果之间的这些群体。多学科研究团队带来了流行病学，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的广泛专业知识。研究人群将来自两个大型综合医疗保健系统的成员，这两个系统位于不同的地理区域，有大量亚洲和太平洋岛民居民（夏威夷和北方加州）。该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10，000人的大规模调查收集患者报告的数据。本研究的目的是：1.描述亚洲人、太平洋岛民和混血API亚群之间CVD患病率的差异; 2.确定人口统计学、临床和心理社会因素是否解释了这些人群中观察到的CVD患病率差异;以及3.描述这些人群中CVD结局的差异，包括生活质量，并确定人口统计学、临床和心理社会因素是否可以解释观察到的差异。 研究结果将提供重要的新证据，说明与美国快速增长的不同人群中CVD患病率和结局相关的潜在因素。这些信息将为多个层面（提供者、患者和卫生系统）的有针对性的干预措施提供战略指导，以降低CVD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.