title: Markedly different clustering of CVD risk factors in New Zealand Indian and European people but similar risk scores (PREDICT-14).
abstract: OBJECTIVE
  To compare the cardiovascular disease (CVD) risk profiles of Indian and European patients from routine primary care assessments in the northern region of New Zealand.
  
  
  METHODS
  Anonymous CVD risk profiles were extracted from PREDICT (a web-based decision support program) for Indian and European patients aged 35-74 years. Linear regression models were used to obtain mean differences adjusted for age, gender and deprivation.
  
  
  RESULTS
  At recruitment, Indian participants (n=8,830) were younger than Europeans (n=47,091), in keeping with national guidelines that recommend earlier CVD risk assessment for Indians. Compared with Europeans, a greater proportion of Indian participants lived in areas of higher deprivation and had a two to four-fold greater burden of diabetes in all age groups. Indian participants had a significantly lower proportion of smokers and a lower mean systolic blood pressure. The respective cardiovascular risk factor profiles lead to similar age-adjusted Framingham five-year CVD risk scores.
  
  
  CONCLUSIONS
  National data sources indicate that there are higher rates of hospitalisations and deaths from CVD in Indians compared with Europeans. Our study found similar predicted CVD risk in these two populations despite markedly different clustering of risk factors, suggesting that the Framingham risk equation may underestimate risk in Indians. There is a need for better ethnicity coding to identify all South Asian ethnicities.
authors.affiliation: Section of Epidemiology and Biostatistics, University of Auckland, New Zealand. laviniap@adhb.govt.nz
authors.forename: Lavinia
authors.initials: L
authors.lastname: Perumal
authors.forename: Susan
authors.initials: S
authors.lastname: Wells
authors.forename: Shanthi
authors.initials: S
authors.lastname: Ameratunga
authors.forename: Romana D
authors.initials: RD
authors.lastname: Pylypchuk
authors.forename: C Raina
authors.initials: CR
authors.lastname: Elley
authors.forename: Tania
authors.initials: T
authors.lastname: Riddell
authors.forename: Andrew
authors.initials: A
authors.lastname: Kerr
authors.forename: Sue
authors.initials: S
authors.lastname: Crengle
authors.forename: Dudley
authors.initials: D
authors.lastname: Gentles
authors.forename: Rod
authors.initials: R
authors.lastname: Jackson
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D044466:Asian People / Q000706:statistics & numerical data*; D002318:Cardiovascular Diseases / Q000453:epidemiology*; D016000:Cluster Analysis; D005060:Europe / Q000208:ethnology; D005260:Female; D054624:Health Status Disparities; D006801:Humans; D007194:India / Q000208:ethnology; D008297:Male; D008875:Middle Aged; D009520:New Zealand / Q000453:epidemiology; D011320:Primary Health Care; D018570:Risk Assessment; D012307:Risk Factors; D044465:White People / Q000706:statistics & numerical data*