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Population-based approaches to understanding disparities in cardiovascular disease risk in the United States

机译：了解美国心血管疾病风险差异的基于人群的方法

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Abstract: This is a comprehensive narrative review of the literature on the current science and evidence of population-level differences in risk factors for heart disease among different racial and ethnic population in the US. It begins by discussing the importance of population-level risk assessment of heart disease in light of the growth rate of specific minority populations in the US. It describes the population-level dynamics for racial and ethnic minorities: a higher overall prevalence of risk factors for coronary artery disease that are unrecognized and therefore not treated, which increases their likelihood of experiencing adverse outcomes and, therefore, potentially higher morbidity and mortality. It discusses the rate of acute coronary syndrome (ACS) in minority communities. Minority patients with ACS are at greater risk of myocardial infarction, rehospitalization, and death from ACS. They also are less likely than nonminority patients to receive potentially beneficial treatments such as angiography or percutaneous coronary intervention. This paper looks at the data surrounding the increased rate of congestive heart failure in racial and ethnic minorities, where the risk is related to the prevalence of comorbidities with hypertension or diabetes mellitus, which, in combination with environmental factors, may largely explain congestive heart failure disparity. The conclusion is it is essential that health care providers understand these various communities, including nuances in disease presentation, risk factors, and treatment among different racial and ethnic groups. Awareness of these communities' attributes as well as differences in incidence, risk factor burdens, prognosis, and treatment are necessary to mitigate racial and ethnic disparities in heart disease.
机译：摘要：这是对当前科学文献的全面叙述性综述，并证明了美国不同种族和族裔人群中心脏病危险因素的人群水平差异。首先，根据美国特定少数族裔人群的增长率，讨论对心脏病进行人群级风险评估的重要性。它描述了种族和少数民族的人口动态：未被识别因此未得到治疗的冠心病危险因素的总体患病率较高，这增加了他们发生不良后果的可能性，因此潜在地增加了发病率和死亡率。它讨论了少数族裔社区中急性冠脉综合征（ACS）的发生率。少数患有ACS的患者罹患心肌梗塞，再次住院以及ACS死亡的风险更高。与非少数族裔患者相比，他们接受血管造影术或经皮冠状动脉介入治疗等潜在有益治疗的可能性也较小。本文着眼于种族和少数民族中充血性心力衰竭发生率增加的数据，这些风险与高血压或糖尿病合并症的患病率有关，结合环境因素，这在很大程度上可以解释充血性心力衰竭差距。结论是至关重要的是，医护人员必须了解这些不同的社区，包括疾病表现，风险因素以及不同种族和民族之间的治疗上的细微差别。必须了解这些社区的属性以及发病率，危险因素负担，预后和治疗方法的差异，以缓解心脏病中的种族和族裔差异。

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