Ethnic differences in common carotid intima-media thickness, and the relationship to cardiovascular risk factors and peripheral arterial disease: the Ethnic-Echocardiographic Heart of England Screening Study.
OBJECTIVE
To compare the mean and maximum common carotid intima-media thickness (CCIMT) in Blacks (Black Caribbean and Black African) and South Asians (People originating from India, Pakistan and Bangladesh) in a population survey and make associations with established cardiovascular risk factors and peripheral arterial disease (PAD).


METHODS
A subset of 492 (293 South Asians and 199 Blacks) out of 572 participants aged ≥ 45 years recruited in a sub-study to the Ethnic-Echocardiographic Heart of England Screening (E-ECHOES) epidemiological study had mean and maximum CCIMT measured. A questionnaire, anthropometric measurements and Ankle Brachial Pressure Index (ABPI) and Intermittent Claudication assessments were made.


RESULTS
Black participants had greater mean but not maximum CCIMT when compared to South Asians overall (P = 0.022), in men (P = 0.04) and in women (P = 0.044). Black ethnicity was an independent predictor of CCIMT even after adjustment for traditional cardiovascular risk factors (P < 0.05). After adjustment for age, ethnicity and traditional cardiovascular risk factors, the presence of PAD remained independently predictive of mean (P = 0.019) and maximum (P = 0.012) CCIMT.


CONCLUSIONS
Black ethnicity is related to greater mean and maximum CCIMT when compared to South Asians, even after adjusting for traditional cardiovascular risk factors. The presence of PAD independently predicts mean and maximum CCIMT adjusting for ethnicity, age and cardiovascular risk factors.
University of Birmingham, Centre for Cardiovascular Sciences, City Hospital, Birmingham B18 7QH, UK.
P C
PC
Bennett
P S
PS
Gill
S
S
Silverman
A D
AD
Blann
G Y H
GY
Lip
D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000208:ethnology; D044383:Black People / Q000208:ethnology; D017536:Carotid Artery, Common / Q000000981:diagnostic imaging*; D003430:Cross-Sectional Studies; D004739:England / Q000453:epidemiology; D005006:Ethnicity; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000453:epidemiology / Q000208:ethnology*; D010865:Pilot Projects; D012307:Risk Factors; D017539:Tunica Intima / Q000000981:diagnostic imaging*; D017540:Tunica Media / Q000000981:diagnostic imaging*; D014463:Ultrasonography; D044465:White People / Q000208:ethnology