在急性心肌梗塞后的种族,社会经济地位和预期寿命
Emily M Bucholz1, Shuangge Ma1, Sharon-Lise T Normand1
1From Yale School of Medicine, New Haven, CT (E.M.B.); Department of Chronic Disease Epidemiology, Yale School of Public Health, New Haven, CT (E.M.B.); Department of Biostatistics, Yale School of Public Health, New Haven, CT (S.M.); Department of Biostatistics, Harvard School of Public Health, and Department of Health Care Policy, Harvard Medical School, Boston, MA (S.-L.T.N.); Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven CT (H.M.K.); Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT (H.M.K.); Robert Wood Johnson Clinical Scholars Program, Department of Medicine (H.M.K.); and the Section of Health Policy and Administration, School of Public Health, Yale University School of Medicine, New Haven, CT (H.M.K.).
在急性心肌梗塞 (AMI) 后的预期寿命因种族和社会经济地位 (SES) 不同. 低SES地区的黑人患者的结果与白人患者相似,而高SES地区的种族差异最大.
科学领域:
- 心脏病学
- 健康上的差异
- 研究成果
背景情况:
- 之前的研究无法分离种族和社会经济地位 (SES) 对急性心肌梗塞 (AMI) 后的长期结果的影响.
- 了解这些差异对于解决心血管保健方面的不平等至关重要.
- 种族和社会经济因素显著影响患者在AMI后的预后.
研究的目的:
- 调查种族,区域级SES和AMI后的预期寿命之间的关系.
- 解开种族和SES对AMI后生存的独立和联合影响.
- 提供旨在减少心血管结果差异的策略.
主要方法:
- 使用来自合作心血管项目的数据, 未来的医疗保险受益者队列.
- 分析了141,095名因AMI住院的患者,随访期为17年.
- 使用Cox比例危险回归与指数模型推断估计预期寿命.
主要成果:
- 在所有SES水平上,黑人患者的预期寿命比白人患者更短,年龄≤75岁.
- 在对患者和治疗特征进行调整后,种族与预期寿命之间的关联仍然存在.
- 在高和中等SES地区的患者中,预期寿命的种族差异最明显,这表明有显著的相互作用 (P=0. 02).
- 年轻的黑人患者 (<68岁) 的预期寿命较短,而老年黑人患者的预期寿命较长.
结论:
- 低SES地区的黑人和白人患者在AMI后的预期寿命相似,与高SES地区的患者相比较短.
- 在AMI后的预期寿命中观察到显著的种族差异,特别是在居住在较高的SES社区的人群中.
- 这些发现突显了种族和SES在长期心血管健康结果中的复杂相互作用.
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