在美国退伍军人中,高血压控制因种族和种族以及地理位置的变化
Kimberly E Lind1, Michelle S Wong1, Stephen E Frochen1
1VA HSR Center for the Study of Healthcare Innovation, Implementation & Policy (CSHIIP) VA Greater Los Angeles Healthcare System Los Angeles CA USA.
Journal of the American Heart Association
|January 10, 2025
概括
在美国退伍军人中,高血压控制因种族和地理位置而异. 黑人和美国印第安人或阿拉斯加原住民退伍军人控制率较低,特定的地理集群需要有针对性的干预措施来减少差异.
科学领域:
- 心血管健康 心血管健康
- 健康差距 研究 研究 研究 研究
- 公共卫生政策 公共卫生政策
背景情况:
- 在美国,高血压控制和心血管结果不够理想,种族,种族和地理差异很大.
- 获得医疗保健是一个关键因素,但残余差异仍然存在.
- 退伍军人事务部 (VA) 的医疗保健系统提供了一个独特的数据集来检查这些差异.
研究的目的:
- 描述美国退伍军人中高血压控制率的流行前,负担得起的医疗法案实施后,跨地理部门和种族/种族群体.
- 评估高血压控制率的空间聚类.
- 为旨在改善心血管结果和减少健康差异的政策和干预提供信息.
主要方法:
- 来自1,619,414名美国退伍军人的电子健康记录的二次数据分析.
- 根据年龄和性别调整的回归模型,以估计按地理部门和种族/种族的控制率.
- 合乐谱映射和空间自相对应分析以确定对照率的聚类.
主要成果:
- 在各个部门,高血压控制率从44.1%到97.5%不等.
- 黑人退伍军人 (72.5%) 和美国印第安人或阿拉斯加原住民退伍军人 (75.4%) 的平均控制率最低.
- 在太平洋西北部,西南部,密苏里州,堪萨斯州和阿肯色州的黑人退伍军人中观察到低控制率的集群;以及在西部和西南部的美洲印第安人或阿拉斯加土著退伍军人中.
结论:
- 高血压控制率的地理差异与退伍军人之间的种族和种族差异相关.
- 干预措施应针对具有集中低高血压控制率的地理区域,以解决这些差异.
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