期刊
PLOS ONE
卷 12, 期 6, 页码 -出版社
PUBLIC LIBRARY SCIENCE
DOI: 10.1371/journal.pone.0178945
关键词
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资金
- National Institute for Health Research [RP-PG-040710314]
- Wellcome Trust [WT/086091/Z/08/Z]
- Medical Research Council [MR/K006584/1]
- Arthritis Research UK
- British Heart Foundation
- Cancer Research UK
- Chief Scientist Office
- Economic and Social Research Council
- Engineering and Physical Sciences Research Council
- National Institute for Health Research
- National Institute for Social Care and Health Research (NIHR)
- Wellcome Trust
- Sir Henry Wellcome Postdoctoral Fellowship from the Wellcome Trust [WT/201375/Z/16/Z]
- Wellcome Trust Clinical Research Training Fellowship [WT/0938/30/Z/10/Z]
- Wellcome Trust Senior Research Fellowship in Clinical Science [WT/098504/Z/12/Z]
- NIHR
- Medical Research Council [MR/K006584/1] Funding Source: researchfish
- National Institute for Health Research [RP-PG-0407-10314] Funding Source: researchfish
Background While the association of ethnic group with individual cardiovascular diseases has been studied, little is known about ethnic differences in the initial lifetime presentation of clinical cardiovascular disease in contemporary populations. Methods and results We studied 1,068,318 people, aged >= 30 years and free from diagnosed CVD at baseline (90.9% White, 3.6% South Asian and 2.9% Black), using English linked electronic health records covering primary care, hospital admissions, acute coronary syndrome registry and mortality registry (CALIBER platform). During 5.7 years median follow-up between 1997-2010, 95,224 people experienced an incident cardiovascular diagnosis. 69.9% (67.2%-72.4%) of initial presentation in South Asian < 60 yrs were coronary heart disease presentations compared to 47.8% (47.3%-48.3%) in White and 40.1% (36.3%-43.9%) in Black patients. Compared to White patients, Black patients had significantly lower age-sex adjusted hazard ratios (HRs) for initial lifetime presentation of all the coronary disease diagnoses (stable angina HR 0.80 (95% CI 0.68-0.93); unstable angina-0.75 (0.59-0.97); myocardial infarction 0.49 (0.40-0.62)) while South Asian patients had significantly higher HRs (stable angina-1.67 (1.52-1.84); unstable angina 1.82 (1.56-2.13); myocardial infarction-1.67 (1.49-1.87). We found no ethnic differences in initial presentation with heart failure (Black 0.97 (0.79-1.20); S Asian 1.04(0.87-1.26)). Compared to White patients, Black patients were more likely to present with ischaemic stroke (1.24 (0.97-1.58)) and intracerebral haemorrhage (1.44 (0.97-2.12)). Presentation with peripheral arterial disease was less likely for Black (0.63 (0.50-0.80)) and South Asian patients (0.70 ( 0.57-0.86)) compared with White patients. Discussion While we found the anticipated substantial predominance of coronary heart disease presentations in South Asian and predominance of stroke presentations in Black patients, we found no ethnic differences in presentation with heart failure. We consider the public health and research implications of our findings.
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