title: Correlates of preclinical cardiovascular disease in Indigenous and Non-Indigenous Australians: a case control study.
abstract: BACKGROUND
  The high frequency of premature death from cardiovascular disease in indigenous Australians is often attributed to the high prevalence of risk factors, especially type II diabetes mellitus (DM). We evaluated the relationship of ethnicity to atherosclerotic burden, as evidenced by carotid intima-media thickness (IMT), independent of risk factor status.
  
  
  METHODS
  We studied 227 subjects (147 men; 50 +/- 13 y): 119 indigenous subjects with (IDM, n = 54), and without DM (InDM, n = 65), 108 Caucasian subjects with (CDM, n = 52), and without DM (CnDM, n = 56). IMT was measured according to standard methods and compared with clinical data and cardiovascular risk factors.
  
  
  RESULTS
  In subjects both with and without DM, IMT was significantly greater in indigenous subjects. There were no significant differences in gender, body mass index (BMI), systolic blood pressure (SBP), or diastolic blood pressure (DBP) between any of the groups, and subjects with DM showed no difference in plasma HbA1c. Cardiovascular risk factors were significantly more prevalent in indigenous subjects. Nonetheless, ethnicity (beta = -0.34; p < 0.0001), age (beta = 0.48; p < 0.0001), and smoking (beta = 0.13; p < 0.007) were independent predictors of IMT in multiple linear regression models.
  
  
  CONCLUSIONS
  Ethnicity appears to be an independent correlate of preclinical cardiovascular disease, even after correction for the high prevalence of cardiovascular risk factors in indigenous Australians. Standard approaches to control currently known risk factors are vital to reduce the burden of cardiovascular disease, but in themselves may be insufficient to fully address the high prevalence in this population.
authors.affiliation: School of Medicine, University of Queensland, Brisbane, Australia. b.haluska@uq.edu.au
authors.forename: Brian A
authors.initials: BA
authors.lastname: Haluska
authors.forename: Lionel
authors.initials: L
authors.lastname: Chan
authors.forename: Leanne
authors.initials: L
authors.lastname: Jeffriess
authors.forename: A Andrew
authors.initials: AA
authors.lastname: Shaw
authors.forename: Joanne
authors.initials: J
authors.lastname: Shaw
authors.forename: Thomas H
authors.initials: TH
authors.lastname: Marwick
mesh_terms: D001315:Australia; D002318:Cardiovascular Diseases / Q000150:complications / Q000000981:diagnostic imaging / Q000208:ethnology*; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging; D016022:Case-Control Studies; D003920:Diabetes Mellitus / Q000208:ethnology; D005260:Female; D006801:Humans; D006973:Hypertension / Q000150:complications / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging; D017540:Tunica Media / Q000000981:diagnostic imaging; D014463:Ultrasonography