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Diferencias raciales en la muerte súbita por ataque cardíaco

Di Zhao1, Wendy S Post1,2, Elena Blasco-Colmenares1

  • 1Departments of Epidemiology and Medicine, and Welch Center for Prevention, Epidemiology, and Clinical Research, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD (D.Z., W.S.P., E.B.-C., E.D.M., E.G.).

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Los negros enfrentan un riesgo significativamente mayor de muerte súbita cardíaca (SCD) en comparación con los blancos, especialmente las mujeres. Los factores socioeconómicos como el ingreso y la educación, junto con los factores de riesgo tradicionales, explican la mayor parte de esta disparidad.

Palabras clave:
Estudios de cohorteLa razaFactores de riesgomuerte súbita por ataque cardíaco

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Área de la Ciencia:

  • Cardiología
  • Salud pública
  • Epidemiología

Sus antecedentes:

  • Los negros presentan una mayor incidencia de muerte súbita cardíaca fuera del hospital (SCD) que los blancos.
  • Las investigaciones anteriores no han evaluado completamente las disparidades raciales en el riesgo acumulado de ECS dentro de grandes cohortes comunitarias.

Objetivo del estudio:

  • Para comparar el riesgo acumulado de SCD durante toda la vida entre las poblaciones negras y blancas.
  • Identificar los factores de riesgo que contribuyen a las diferencias raciales en el riesgo de ECS.

Principales métodos:

  • Un estudio de cohorte en el que participaron 3832 participantes negros y 11.237 blancos del Estudio de Riesgo de Aterosclerosis en las Comunidades (ARIC).
  • Se adjudicaron casos de ECS y se calculó la incidencia acumulada utilizando modelos de riesgo competidores.
  • Los posibles factores mediadores incluyen la demografía, el estatus socioeconómico, los factores de riesgo cardiovascular y los parámetros electrocardiográficos.

Principales resultados:

  • A lo largo de 27,4 años, la ECS se produjo en 215 individuos negros y 332 blancos.
  • La incidencia acumulada de SCD a la edad de 85 años fue más alta para los hombres negros (9,6%) y más baja para las mujeres blancas (2,3%).
  • Los factores conocidos explicaron el 65.3% del exceso de riesgo de ECS en los negros frente a los blancos, con ingresos, educación, hipertensión y diabetes como contribuyentes clave.

Conclusiones:

  • Los negros, especialmente las mujeres, tienen un riesgo sustancialmente mayor de ECS en comparación con los blancos.
  • Los factores de riesgo socioeconómicos y cardiovasculares tradicionales representan una parte significativa de la disparidad racial en la ECS.
  • Las disparidades observadas entre las razas y los géneros en la carga de la ECS ponen de relieve un desafío crítico de salud pública y clínico.