心力衰竭中的种族和功能障碍:黑人与白人之间的死亡率
Grace L Smith1, Michael G Shlipak, Edward P Havranek
1Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Conn 06520, USA.
Circulation
|March 17, 2005
概括
功能障碍增加了心力衰竭 (HF) 患者的死亡风险. 然而,与功能障碍相关的死亡风险在白人患者中比黑人患者更为明显.
科学领域:
- 心脏病学 心脏病学
- 腎臟病學 (nephrology) 是一種醫學專業.
- 公共卫生 公共卫生
背景情况:
- 功能障碍是心力衰竭 (HF) 的日益公认的预后因素.
- 在HF和病进展方面存在种族差异.
- 功能障碍对HF患者预后的种族差异影响仍然不清楚.
研究的目的:
- 在HF患者中,确定与肌素升高和估计球过率 (eGFR) 损失相关的1年死亡风险.
- 量化患有功能障碍的HF患者死亡风险的种族差异.
主要方法:
- 全国心脏护理项目队列的回顾性评估.
- 对53,640名医疗保险患者的分析,这些患者因高频率住院.
- 在黑色和白色患者小组中评估肌素水平和eGFR.
主要成果:
- 较高的肌素水平与增加的死亡风险有关,种族之间的数量不同 (相互作用P=0.0001).
- 肌素0.5mg/dL增加与黑人死亡率增加>10%,而白人死亡率增加>15%.
- 死亡风险的种族差异在较高水平的功能障碍中最为明显,对于肌素和eGFR都是一致的.
结论:
- 功能障碍预测老年HF患者的死亡率更高,白人患者的风险更大.
- 黑人和白人高风险肺炎患者之间发病率和死亡率负担的显著差异凸显了改善风险分层和向治疗的必要性.
- 进一步的研究至关重要,以探索在HF和功能障碍结果中观察到的种族差异的生理基础.
相关概念视频
Stereotypes, Prejudice, and Discrimination
Humans are very diverse and although we share many similarities, we also have many differences. The social groups we belong to help form our identities (Tajfel, 1974). These differences may be difficult for some people to reconcile, which may lead to prejudice toward people who are different. Prejudice is a negative attitude and feeling toward an individual based solely on one’s membership in a particular social group (Allport, 1954; Brown, 2010). Prejudice is common against people who are...
Changes in Skin Color: Clinical Perspectives
The first thing a clinician sees is the skin, so the examination of the skin should be part of any thorough physical examination. Most skin disorders are relatively benign, but a few, including melanomas, can be fatal if untreated. A couple of the more noticeable disorders, albinism and vitiligo, affect the appearance of the skin and its accessory organs.
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Albinism
Albinism is a genetic disorder that affects (completely or partially) the coloring of skin, hair, and eyes. The defect is primarily...
Photoreceptors and Visual Pathways
At the molecular level, visual signals trigger transformations in photopigment molecules, resulting in changes in the photoreceptor cell's membrane potential. The photon's energy level is denoted by its wavelength, with each specific wavelength of visible light associated with a distinct color. The spectral range of visible light, classified as electromagnetic radiation, spans from 380 to 720 nm. Electromagnetic radiation wavelengths exceeding 720 nm fall under the infrared category, whereas...
Heart Failure IV: Classification and Diagnostic Evaluation
Heart failure can be classified in various ways, with the most common classifications based on physical activity limitations, disease progression, severity, and treatment strategies.The Functional Classification of Heart Failure divides patients into four categories based on physical activity limitation due to symptom burden.Class I: Patients in this class have cardiac disease but no physical activity limitations. Ordinary activities like walking, climbing stairs, or routine tasks do not cause...
Hazard Rate
The hazard rate, also known as the hazard function or failure rate, is a statistical measure used to describe the instantaneous rate at which an event occurs, given that the event has not yet happened. From a probabilistic perspective, it represents the likelihood that a subject will experience the event in a very small time interval, conditional on surviving up to the beginning of that interval. In terms of frequency, the hazard rate can be viewed as the ratio of the number of events to the...
Close Relationships and Culture
Culture shapes how people approach attraction, choose partners, and build long-term relationships. While some preferences in mate selection appear consistent across cultures, such as men valuing physical attractiveness and women emphasizing financial resources, cultural contexts influence how these preferences are expressed and prioritized. Marriage extends beyond romantic ideals in many societies and is deeply embedded in social, economic, and religious frameworks.The Role of Culture in Mate...


