Ethnic differences in cardiovascular disease risk factors and diabetes status for Pacific ethnic groups and Europeans in the Diabetes Heart and Health Survey (DHAH) 2002-2003, Auckland New Zealand.
OBJECTIVE
The aim of this paper is to provide levels of cardiovascular disease (CVD) risk factors and diabetes status for Pacific ethnic groups and make comparisons amongst these groups (Samoan, Tongan, Niuean, Cook Islanders) with European New Zealanders by gender from the 2002-03 DHAH Survey.


METHODS
The DHAH was a cross-sectional population-based survey and was carried out in Auckland between 2002-03. A total of 1011 Pacific comprising of 484 Samoan, 252 Tongan, 109 Niuean, 116 Cook Islanders, and 47 Other Pacific (mainly Fijian) and 1745 European participants took part in the survey. Participants answered a self-administered questionnaire to assess whether they had previously diagnosed CVD risk factors (blood pressure, cholesterol, diabetes) and lifestyle risk factors (smoking, physical inactivity). All participants provided an early morning mid-stream urine sample, an initial blood test and full glucose tolerance test (GTT) for those not previously diagnosed with diabetes.


RESULTS
In both men and women, CVD risk among the Pacific groups were all significantly higher than Europeans. Niueans had the lowest Pacific CVD risk and Samoans had the highest estimated risk. Individual risk factors differed between the groups, however; the most observable differences were the more adverse lipid profile in Tongan men and the lower total cholesterol and micro-albumin in Niuean women when compared to their Samoan counterparts. Diabetes prevalence was highest in Samoan men (26.2%) and Tongan women (35.8%). Tongan women had a diabetes prevalence over double that of their men (17.8%), whereas in the other Pacific groups, male and female prevalence was very similar. Niueans had the lowest diabetes prevalence of both sexes (men 14.9%, women 10.8%). Undiagnosed diabetes as a proportion of total diabetes was similar in Samoan, Niuean and Cook Islands groups (1/4-5) suggesting efficient screening. Cook Islanders had a ratio of one undetected diabetes case for every two known cases.


CONCLUSIONS
CVD risk factors, diabetes prevalence, and levels of undetected diabetes differed between the Pacific ethnic groups with Niueans having the healthiest profile. More rigorous screening of diabetes in Cook Islanders is needed if they are to experience similar detection rates as other Pacific Island communities in New Zealand. Greater attention is required to identify and manage CVD risk among all Pacific peoples to reduce the gap in CVD risk factors, morbidity and mortality when compared to European New Zealanders.
Sundborn
Gerhard
G
Section of Epidemiology and Biostatistics, School of Population Health, University of Auckland, Private Bag 92019, Auckland 1142, New Zealand. g.sundborn@auckland.ac.nz
Metcalf
Patricia A
PA
Gentles
Dudley
D
Scragg
Robert K R
RK
Schaaf
David
D
Dyall
Lorna
L
Black
Peter
P
Jackson
Rod
R
D000328:Adult; D000368:Aged; D001786:Blood Glucose; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus / Q000453:epidemiology*; D005006:Ethnicity / Q000145:classification*; D015444:Exercise; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D015995:Prevalence; D012307:Risk Factors; D011795:Surveys and Questionnaires
D001786:Blood Glucose