Ethnic differences in mortality from cardiovascular disease in the UK: do they persist in people with diabetes?
OBJECTIVE
To determine whether ethnic differences in cardiovascular disease mortality persist in people with non-insulin-dependent diabetes mellitus.


METHODS
This was an ecological study in which routine mortality data from 1985-86, which coded all mentioned causes of death, provided the numerator. The UK population derived from 1981 census formed the denominator.


METHODS
United Kingdom.


METHODS
Records of all deaths in people aged 45 years and above were extracted if diabetes was mentioned anywhere on the death certificate. The denominator was aged five years to approximate to the 1986 population. Mortality rates where a cardiovascular underlying cause was given were compared between South Asians, African-Caribbeans, and those born in England and Wales. The latter group formed the standard for directly standardised rate ratios.


RESULTS
Mortality from heart disease was approximately three times higher in diabetic South Asian born men and women than in those with diabetes born in England and Wales. This ethnic difference was greatest in the younger age group. Conversely, stroke mortality rates in African-Caribbeans were 3.5-4 times higher than those in the England and Wales population. Despite this high mortality from stroke, ischaemic heart disease death rates were not high in African-Caribbean men.


CONCLUSIONS
Ethnic differences in cardiovascular mortality persisted and were greater in those with diabetes. Thus the high risk of heart disease should be targeted for intervention in South Asians, and the high rates of stroke targeted in African-Caribbeans.
Chaturvedi
N
N
Department of Epidemiology and Public Health, University College London.
Fuller
J H
JH
D017677:Age Distribution; D000368:Aged; D001210:Asia, Southeastern / Q000208:ethnology; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000401:mortality; D003924:Diabetes Mellitus, Type 2 / Q000208:ethnology* / Q000401:mortality; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D006113:United Kingdom / Q000453:epidemiology; D014900:West Indies / Q000208:ethnology