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突然 の 心臓 発作 死 に 関する 人種 の 違い

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.).

Circulation
|February 5, 2019
PubMed
まとめ

黒人は白人と比べて 急性心臓死 (SCD) のリスクが著しく高く,特に女性はそうである. 収入や教育などの社会経済的要因と 伝統的なリスク要因が この格差のほとんどを説明しています

キーワード:
コホート研究人種リスク要因心臓発作による突然死

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科学分野:

  • 心臓病科
  • 公衆衛生
  • 流行病学

背景:

  • 黒人は白人より病院外突然心臓死 (SCD) の発生率が高い.
  • 以前の研究は,大規模なコミュニティ内の累積的なSCDリスクにおける人種差を完全に評価していなかった.

研究 の 目的:

  • 黒人と白人の集団における SCD の生涯累積リスクを比較する.
  • SCD リスクにおける人種差異に寄与する危険因子を特定する.

主な方法:

  • Atherosclerosis Risk in Communities (ARIC) の黒人3832人,白人11237人を対象としたコホート研究である.
  • SCDの症例は判定され,累積的な発生率は競合するリスクモデルを使用して計算されました.
  • 潜在的仲介因子には,人口統計,社会経済的地位,心血管リスク因子,および心電図のパラメータが含まれています.

主要な成果:

  • 27. 4年間,SCDは215人の黒人と332人の白人に発生しました.
  • 85歳におけるSCDの生涯累積発生率は黒人男性 (9. 6%) で最も高く,白人女性 (2. 3%) で最も低かった.
  • 既知の要因は,白人に対して黒人のSCDリスクの65.3%を説明し,収入,教育,高血圧,糖尿病が主な要因である.

結論:

  • 黒人,特に女性は白人に比べて SCD のリスクがかなり高い.
  • 社会経済と伝統的な心血管疾患のリスク要因は,SCDにおける人種差の大きな部分を占めています.
  • SCDの負担における人種と性別の格差は,公衆衛生と臨床上の重大な課題を強調しています.