基于夏威夷医疗保险数据的阿尔茨海默病患者的心脑血管疾病风险和种族/民族差异

IF 2.8 Q2 NEUROSCIENCES
Journal of Alzheimer's disease reports Pub Date : 2024-11-24 eCollection Date: 2024-01-01 DOI:10.1177/25424823241289038
Chathura Siriwardhana, Enrique Carrazana, Kore Liow, John J Chen
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引用次数: 0

摘要

背景:阿尔茨海默病(AD)和心脑血管疾病(CVD)是老年人关注的重要疾病,具有重叠的危险因素。夏威夷独特的人口结构以其强烈的种族多样性为特征,显示出明显的种族健康差异。例如,夏威夷原住民/太平洋岛民(NHPI)人口被确定为多种健康状况(包括心血管疾病)的高风险群体。目的:本研究利用夏威夷医疗保险数据,调查AD对发生心血管疾病风险的影响,重点关注种族影响。方法:采用长达9年的夏威夷医疗保险数据,本研究确定了诊断为AD的老年患者,这些患者随后发展为心力衰竭(HF)、缺血性心脏病(IHD)、心房颤动(AF)、急性心肌梗死(AMI)或中风。为了评估心血管疾病的风险,我们使用了多状态模型和倾向评分匹配对照。此外,我们评估了这些疾病的种族和民族风险差异,同时考虑了其他相关风险因素。结果:我们的研究结果显示,在诊断为AD的个体中,AMI、HF和IHD的风险升高。此外,社会经济地位(SE)被确定为心脑血管疾病风险的关键因素。在低SE组中,与白人相比,nhpi患HF和IHD的风险增加。有趣的是,高SE组的nhpi显示HF的风险降低。结论:AD的存在增加了AMI、HF和IHD发生的可能性。此外,心血管疾病的风险似乎受到夏威夷种族/民族以及社会经济地位的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cardio and cerebrovascular diseases risk among Alzheimer's disease patients and racial/ethnic disparities, based on Hawaii Medicare data.

Background: Alzheimer's disease (AD) and cardiovascular and cerebrovascular diseases (CVD) are significant concerns among the elderly, sharing overlapping risk factors. Hawaii's unique demographic profile, characterized by its strong ethnic diversity, shows marked racial health disparities. For instance, the Native Hawaiian/Pacific Islander (NHPI) population is identified as a high-risk group for multiple health conditions, including CVD.

Objective: This study investigates the impact of AD on the risk of developing CVD, with a focus on racial influences, utilizing Hawaii Medicare data.

Methods: Employing nine years of longitudinal Hawaii Medicare data, this study identified elderly patients diagnosed with AD who subsequently developed heart failure (HF), ischemic heart disease (IHD), atrial fibrillation (AF), acute myocardial infarction (AMI), or stroke. To assess the risk of CVD, we utilized multistate models and employed propensity score-matched controls. Additionally, we evaluated racial and ethnic differences in the risk of these diseases, while accounting for other relevant risk factors.

Results: Our findings revealed an elevated risk of AMI, HF, and IHD among individuals diagnosed with AD. Additionally, socioeconomic status (SE) was identified as a crucial factor in the risk of cardio and cerebrovascular diseases. Within the low SE group, NHPIs exhibited increased risks of HF and IHD compared to their white counterparts. Interestingly, NHPIs demonstrated reduced risks of HF in the higher SE group.

Conclusions: The presence of AD increases the likelihood of developing AMI, HF, and IHD. Moreover, the risk of CVD appears to be influenced by race/ethnicity in Hawaii, as well as socioeconomic status.

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