High rates of ischaemic heart disease in Scotland are not explained by conventional risk factors.
OBJECTIVE
To (1) compare prevalence of socioeconomic, behavioural, and physiological ischaemic heart disease (IHD) risk factors in Scotland with a comparable nation (England) and (2) find out if their distribution explains Scotland's comparatively higher IHD rate (1.62 (1.30, 2.02)).


METHODS
Cross sectional, individual level observational study with data on socioeconomic, behavioural, and physiological characteristics, 6064 respondents from Scotland and England, (2362 and 3702 respectively), aged 45-74 and with data on all required items.


RESULTS
There were significant and meaningful differences between the Scottish and English in the prevalence of several IHD risk factors. However, a substantially and significantly higher risk of IHD persisted among the Scottish respondents (1.50 (1.17, 1.91)) despite control for a wide range of risk factors.


CONCLUSIONS
Interpretation must be cautious because these are cross sectional data, however higher levels of conventional IHD risk factors contribute to but do not explain the comparatively high rates of IHD in Scotland. Alternative explanations for, and policy interventions to tackle, Scottish rates of IHD must be considered.
Mitchell
Richard
R
Research Unit in Health, Behaviour and Change, University of Edinburgh Medical School, Teviot Place, Edinburgh EH8 9AG, UK. Richard.Mitchell@ed.ac.uk
Fowkes
Gerry
G
Blane
David
D
Bartley
Mel
M
D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D015444:Exercise; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000453:epidemiology* / Q000209:etiology*; D009765:Obesity / Q000150:complications / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012959:Socioeconomic Factors; D013315:Stress, Psychological / Q000150:complications / Q000453:epidemiology