Prevention of coronary heart disease with statins in UK South Asians and Caucasians.
OBJECTIVE
To determine the prevalence of subjects eligible for primary and secondary prevention of coronary heart disease (CHD) among the British South Asian population and to compare that with British Caucasians.


RESULTS
We used the Health Survey for England 1998 and 1999 datasets, holding data on 9950 Caucasians and 1938 South Asians. Thresholds for treatment were a total cholesterol >3.5 mmol/l and either a history of cardiovascular disease or elevated estimated CHD risk, adjusted where necessary for ethnic differences. Separate analyses were performed for primary prevention risk thresholds of >15% and >30% over 10 years. The prevalence of previous myocardial infarction, angina, or stroke was higher in South Asian men than in Caucasian but the reverse was seen in women. More than 93% [95% confidence interval (CI) 88-97] of South Asian men and nearly 68% (95% CI 66-71) of Caucasian men older than 55 years have a CHD risk greater than 15% (equivalent to cardiovascular risk of 20%) and a cholesterol above 3.5 mmol/l and would be eligible for treatment with lipid-lowering drugs. The equivalent proportions in women are 55% (95% CI 46-65) and 18% (95% CI 16-20) in South Asians and Caucasians, respectively.


CONCLUSIONS
Treating this proportion of the population will have a societal impact, the majority of older people becoming patients, and although it may well be cost-effective for individuals, it will require substantial new resources.
Aarabi
Mohsen
M
Academic Unit of Clinical Pharmacology, Division of Clinical Sciences (South), University of Sheffield, Royal Hallamshire Hospital, Sheffield, UK.
Jackson
Peter R
PR
D000328:Adult; D000367:Age Factors; D000368:Aged; D000704:Analysis of Variance; D044466:Asian People; D003327:Coronary Disease / Q000453:epidemiology / Q000208:ethnology* / Q000517:prevention & control*; D003365:Costs and Cost Analysis; D004739:England / Q000208:ethnology; D005260:Female; D006306:Health Surveys; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000191:economics / Q000592:standards / Q000627:therapeutic use*; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D015995:Prevalence; D011322:Primary Prevention; D012307:Risk Factors; D016896:Treatment Outcome; D014852:Wales / Q000208:ethnology; D044465:White People
D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors