title: Association of physical activity, smoking, and alcohol intake with CVD-related hospital discharge in people of European, South Asian, or African descent.
abstract: BACKGROUND
  It is unclear whether the beneficial effects of certain lifestyle factors are equally strong in ethnic minority populations in Europe. This study explores whether this association of physical activity, smoking, and alcohol intake with cardiovascular disease (CVD)-related hospital discharge differs among South Asian Surinamese, African Surinamese, or Dutch descent living in the Netherlands.
  
  
  METHODS
  Prospective cohort.
  
  
  METHODS
  We obtained baseline data from 370 South Asian, 689 African, and 567 Dutch participants (aged 35-60 years) of the SUNSET study (2001-2003). Follow up ended in December 2007. We used Cox proportional hazards models to study the associations of lifestyle factors with CVD-related hospital discharge.
  
  
  RESULTS
  In the overall study population, low amount of physical activity (hazard ratio, HR 1.88, 95% CI 1.23-2.86), current smoking (HR 1.63, 95% CI 1.20-2.22), and nondrinking (HR 1.52, 95% CI 1.04-2.23) were associated with CVD-related hospital admission. There was no statistically significant effect of ethnicity on these associations. For instance, the adjusted HR for CVD-related hospital discharge regarding a low amount of physical activity was 2.77 (95% CI 1.31-5.87) for Africans, 1.53 (95% CI 0.76-3.05) for South Asians, and 1.55 (95% CI 0.73-3.30) for the Dutch. The p-value for ethnicity by lifestyle interaction was 0.41.
  
  
  CONCLUSIONS
  We did not find a different association across ethnic groups of South Asian Surinamese, African Surinamese, or Dutch descent between physical activity, smoking, and alcohol intake and 5-year hazard of a CVD-related hospital discharge. We recommend confirmation in multiethnic studies in other contexts.
authors.affiliation: Academic Medical Center, University of Amsterdam, The Netherlands. j.s.demunter@amc.uva.nl
authors.forename: Jeroen S l
authors.initials: JS
authors.lastname: de Munter
authors.forename: Charles
authors.initials: C
authors.lastname: Agyemang
authors.forename: Karien
authors.initials: K
authors.lastname: Stronks
authors.forename: Irene G M
authors.initials: IG
authors.lastname: van Valkengoed
mesh_terms: D000328:Adult; D000428:Alcohol Drinking / Q000453:epidemiology*; D044466:Asian People; D044383:Black People; D002318:Cardiovascular Diseases / Q000453:epidemiology / Q000208:ethnology*; D015331:Cohort Studies; D015444:Exercise / Q000502:physiology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009426:Netherlands / Q000453:epidemiology; D010351:Patient Discharge / Q000706:statistics & numerical data*; D016016:Proportional Hazards Models; D011446:Prospective Studies; D012907:Smoking / Q000453:epidemiology*; D011795:Surveys and Questionnaires; D044465:White People