RESUMO
BACKGROUND: Although obstructive lung disease (OLD), which includes COPD, affects all the populations, Hispanics seem to be protected against COPD development and progression. Whether this advantage translates into a survival benefit for this population is unknown. We aimed to determine the risk for OLD in Mexican Americans, the largest US Hispanic subgroup, compared with non-Hispanic whites and to assess all-cause mortality in subjects with OLD. METHODS: We assessed the relationships between Mexican American ethnicity and spirometric OLD and risk of death among 6,456 US adults aged ≥ 40 years who participated in the Third National Health and Nutritional Examination Survey Follow-up Study. We used logistic and Cox regression analyses to estimate the OR for OLD among Mexican Americans and the hazard ratio (HR) for all-cause mortality among Mexican Americans with OLD, respectively. RESULTS: After adjustment for demographic factors, socioeconomic status, and COPD risk factors, Mexican Americans had decreased odds of OLD diagnosis compared with whites (OR, 0.72 [95% CI, 0.54-0.95]). Among the 1,734 participants with OLD, 1,054 (60.8%) died during median follow-up of 12 years. In an adjusted model, Mexican Americans had no advantage in mortality from all causes (HR, 0.88 [95% CI, 0.69-1.13]). After accounting for the fact that some Mexican Americans may have moved back to Mexico and died there (thus, had no US death certificate), there was still no difference in mortality between these groups. CONCLUSIONS: Although Mexican Americans appear to have lower risk for OLD, subjects of this ethnicity with OLD do not seem to have a survival advantage.
Assuntos
Pneumopatias Obstrutivas/diagnóstico , Pneumopatias Obstrutivas/mortalidade , Americanos Mexicanos/estatística & dados numéricos , Inquéritos Nutricionais/estatística & dados numéricos , População Branca/estatística & dados numéricos , Adulto , Idoso , Demografia , Feminino , Seguimentos , Humanos , Pneumopatias Obstrutivas/etnologia , Masculino , Americanos Mexicanos/etnologia , Pessoa de Meia-Idade , Análise de Regressão , Fatores de Risco , Classe Social , Taxa de Sobrevida , Estados Unidos , População Branca/etnologiaRESUMO
O autor aborda a epidemiologia da doença pulmonar obstrutiva crônica, discutindo sua gênese e sua prevençäo. Comenta sobre as manifestaçöes sistêmica da doença e sobre o comportamento de outros órgäos à distância,sugerindo uma nova denominaçäo para a entidade: doença pulmonar sistêmica obstrutiva crônica. Enfoca os dados sobre sua prevalência em diferentes partes do mundo e sobre o custo financeiro que ela provoca, decorrente do seu manejo e da incapacidade que causa. Aponta e discute os diferentes fatores envolvidos em sua gênese que vêm sendo apresentados na literatura especializada. Finaliza por apresentar as estratégias possíveis para os diferentes níveis de prevençäo da doença, desde a primária até a terciária
Assuntos
Pneumopatias Obstrutivas/epidemiologia , Pneumopatias Obstrutivas/etnologia , Pneumopatias Obstrutivas/prevenção & controleAssuntos
Pneumopatias Obstrutivas/genética , Repetições de Microssatélites/genética , Polimorfismo Genético , Surfactantes Pulmonares/genética , Predisposição Genética para Doença , Genótipo , Glicoproteínas/genética , Humanos , Incidência , Pneumopatias Obstrutivas/etnologia , México/epidemiologia , Proteolipídeos/genética , Proteína D Associada a Surfactante Pulmonar , Proteínas Associadas a Surfactantes Pulmonares , Fatores de Risco , Fumar/efeitos adversos , Fumar/genética , Fumar/metabolismoRESUMO
Prevalence rates of respiratory symptoms and diseases in a large group of Anglos and Mexican-Americans were analyzed. Each subject completed a questionnaire. Among current smokers, chronic productive cough and dyspnea were significantly higher in both ethnic groups; wheezy symptoms were higher in Anglos. There were no significant differences in the symptom prevalence rates between the two groups, after stratifying by current cigarette consumption and CRT. The spirometric values were not significantly different. In both ethnic groups, the prevalence rates of wheeze, SOBWHZ and asthma were significantly higher in those who had CRT. Among Anglos, less educated smokers had significantly higher prevalence rates of SOBWHZ and dyspnea; nonsmokers with less education had higher prevalence rates of cough, chronic cough and dyspnea. Our results confirm the importance of CRT and lower educational level as risk factors for respiratory symptoms. Ethnicity is not associated with symptomatology or lung function impairment.
Assuntos
Hispânico ou Latino , Pneumopatias Obstrutivas/etnologia , Adulto , Arizona/epidemiologia , Tosse/etnologia , Dispneia/etnologia , Escolaridade , Humanos , Masculino , México/etnologia , Pessoa de Meia-Idade , Prevalência , Sons Respiratórios , Fatores de Risco , Fumar/etnologia , EspirometriaRESUMO
We examined mortality from lung cancer and from chronic obstructive pulmonary disease in Hispanic White, Other White, and Native American residents of New Mexico during the period 1958-82. Age-specific mortality was calculated by combining death certificate data with population estimates based on the 1960, 1970, and 1980 censuses that were adjusted for inconsistencies in the designation of race and ethnicity. In Other Whites, age-adjusted mortality rates from lung cancer and from chronic obstructive pulmonary disease increased progressively in males and females. Mortality rates for both diseases also increased in Hispanics during the study period, but the most recent rates for Hispanics were well below those for Other Whites. Age-specific mortality rates for lung cancer declined for more recently born Hispanic women at older ages. In Native Americans, rates for both diseases were low throughout the study period and did not show consistent temporal trends.