Comparative levels and time trends in blood pressure, total cholesterol, body mass index and smoking among Caucasian and South-Asian participants of a UK primary-care based cardiovascular risk factor screening programme.
BACKGROUND
Individuals of South-Asian origin have a comparatively higher cardiovascular disease burden, but there is uncertainty about whether this is due to differences in risk factor levels and trends. We therefore studied comparative levels and time trends in blood pressure (BP), total cholesterol, body mass index (BMI) and current smoking among UK Caucasian and South-Asian individuals.


METHODS
Repeatable cross-sectional survey of men and women aged 35-60 attending for first screening as part of a primary-care based cardiovascular risk factor screening programme 1989 and 1999.


RESULTS
Of 34,122 men and 37,294 women participants, 499 men (1.5%)and 381 women (1%) were of South-Asian origin. South-Asian men had lower systolic [(-4.91 mmHg (95% Confidence Iterval (CI): -3.58 to -6.23)] and diastolic BP [-2.87 mmHg (-2.02 to -3.72)], with no significant differences in cholesterol and BMI. South-Asian women had lower systolic BP [-1.77 mmHg, 95% (-0.21 to -3.33)], diastolic BP [-1.87 mmHg (-0.92 to -2.82)], cholesterol [-0.24 mmol/l (-0.08 to -0.39)]; and higher BMI [+0.78 kg/m2 (0.25 to 1.3)]. South-Asian men and women had significantly lower prevalence of self-reported current smoking (29.0% and 1.8% respectively). With the exception of self-reported current smoking, between ethnic group risk factor trends were not converging.


CONCLUSIONS
With the exception of women's BMI, South-Asian individuals had either lower or similar levels of the examined cardiovascular risk factor levels, compared with Caucasian individuals. Although time trends in smoking were converging, other risk factors trends were similar between the two ethnic groups. Overall the findings do not support the hypothesis that the relatively high cardiovascular disease burden in UK South-Asians is due to higher levels exposure to the examined risk factors. Other hypotheses, such as higher frequency of diabetes and increased genetic predisposition, require further exploration.
Lyratzopoulos
Georgios
G
Directorate of Public Health and Clinical Services, Norfolk, Suffolk and Cambridgeshire Strategic Health Authority, Cambridge, UK. georgios.lyratzopoulos@nscsha.nhs.uk
McElduff
Patrick
P
Heller
Richard F
RF
Hanily
Margaret
M
Lewis
Philip S
PS
D000328:Adult; D000428:Alcohol Drinking / Q000208:ethnology; D001210:Asia, Southeastern / Q000208:ethnology; D001794:Blood Pressure / Q000502:physiology; D015992:Body Mass Index; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology*; D002784:Cholesterol / Q000097:blood; D005260:Female; D006801:Humans; D006973:Hypertension / Q000208:ethnology; D008297:Male; D008403:Mass Screening; D008875:Middle Aged; D044468:Native Hawaiian or Pacific Islander / Q000706:statistics & numerical data*; D015995:Prevalence; D011320:Primary Health Care / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D012907:Smoking / Q000208:ethnology; D006113:United Kingdom / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*
D002784:Cholesterol