title: Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. II. Differences in risk factor levels.
abstract: OBJECTIVE
  The aim of the study was to examine cardiovascular risk factors to see how these might explain differences in cardiovascular disease mortality among Chinese, Malays, and Indians in the Republic of Singapore.
  
  
  METHODS
  The study was a population based cross sectional survey. Stratified systematic sampling of census districts, reticulated units, and houses was used. The proportions of Malay and Indian households were increased to improve statistical efficiency, since about 75% of the population is Chinese.
  
  
  METHODS
  Subjects were recruited from all parts of the Republic of Singapore.
  
  
  METHODS
  2143 subjects aged 18 to 69 years were recruited (representing 60.3% of persons approached). There were no differences in response rate between the sexes and ethnic groups.
  
  
  RESULTS
  Data on cardiovascular risk factors were collected by questionnaire. Measurements were made of blood pressure, serum cholesterol, low and high density lipoprotein cholesterol, fasting triglycerides and plasma glucose. In males the age adjusted cigarette smoking rate was higher in Malays (53.3%) than in Chinese (37.4%) or Indians (44.5%). In both sexes, Malays had higher age adjusted mean systolic blood pressure: males 124.6 mm Hg v 121.2 mm Hg (Chinese) and 121.2 mm Hg (Indians); females 122.8 mm Hg v 117.3 mm Hg (Chinese) and 118.4 mm Hg (Indians). Serum cholesterol, low density lipoprotein cholesterol and triglyceride showed no ethnic differences. Mean high density lipoprotein cholesterol in males (age adjusted) was lower in Indians (0.69 mmol/litre) than in Chinese (0.87 mmol/litre) and Malays (0.82 mmol/litre); in females the mean value of 0.95 mmol/litre in Indians was lower than in Chinese (1.05 mmol/litre) and Malays (1.03 mmol/litre). Rank prevalence of diabetes for males was Indians (highest), Malays and then Chinese; for females it was Malays, Indians, Chinese.
  
  
  CONCLUSIONS
  The higher mortality from ischaemic heart disease found in Indians in Singapore cannot be explained by the major risk factors of cigarette smoking, blood pressure and serum cholesterol; lower high density lipoprotein cholesterol and higher rates of diabetes may be part of the explanation. The higher systolic blood pressures in Malays may explain their higher hypertensive disease mortality.
authors.affiliation: National University of Singapore, Department of Community, Occupational and Family Medicine.
authors.forename: K
authors.initials: K
authors.lastname: Hughes
authors.forename: P P
authors.initials: PP
authors.lastname: Yeo
authors.forename: K C
authors.initials: KC
authors.lastname: Lun
authors.forename: A C
authors.initials: AC
authors.lastname: Thai
authors.forename: S P
authors.initials: SP
authors.lastname: Sothy
authors.forename: K W
authors.initials: KW
authors.lastname: Wang
authors.forename: J S
authors.initials: JS
authors.lastname: Cheah
authors.forename: W O
authors.initials: WO
authors.lastname: Phoon
authors.forename: P
authors.initials: P
authors.lastname: Lim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001786:Blood Glucose / Q000032:analysis; D001794:Blood Pressure; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000401:mortality; D002681:China / Q000208:ethnology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D007194:India / Q000208:ethnology; D008055:Lipids / Q000097:blood; D008296:Malaysia / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012846:Singapore; D012907:Smoking / Q000009:adverse effects
chemical_list: D001786:Blood Glucose; D008055:Lipids