title: Ethnicity and risk of cardiovascular disease (CVD): 4.8 year follow-up of patients with type 2 diabetes living in Scotland.
abstract: OBJECTIVE
  Potential differences in cardiovascular risk by ethnicity remain uncertain. We evaluated the association of ethnicity with cardiovascular disease (CVD) incidence in a large cohort of people with type 2 diabetes living in Scotland.
  
  
  METHODS
  Data from Scottish Care Information-Diabetes (SCI-Diabetes) were linked to Scottish Morbidity Records (SMR01) and National Records of Scotland data for mortality for dates between 2005 and 2011. Of 156,991 people with type 2 diabetes with coded ethnicity, 121,535 (77.4%) had no CVD at baseline (White: 114,461; Multiple Ethnic: 2,554; Indian: 797; Other Asian: 319; Pakistani: 2,250; Chinese: 387; African-Caribbean: 301 and Other: 466) and were followed up (mean ± SD: 4.8 ± 2.3 years) for the development of fatal and non-fatal CVD.
  
  
  RESULTS
  During follow-up, 16,265 (13.4%) patients developed CVD (ischaemic heart or cerebrovascular diseases). At baseline, Pakistanis were younger and had developed diabetes earlier, had higher HbA1c and longer duration of diabetes, but had lower BP, BMI, creatinine, proportion of smokers and proportion on antihypertensive therapy than whites. The age and sex adjusted HRs for CVD were HR 1.31 (CI 1.17, 1.47), p < 0.001 in Pakistanis and HR 0.66 (CI 0.47, 0.92), p = 0.014 in Chinese compared with whites. Adjusting additionally for an area measure of deprivation, duration of diabetes, conventional CVD and other risk factors, the HR for Pakistanis (HR 1.45 [CI 1.14, 1.85], p = 0.002) was significantly higher, and that for Chinese (HR = 0.58 [CI 0.24, 1.40], p = 0.228) lower, compared with whites.
  
  
  CONCLUSIONS
  Compared with whites with type 2 diabetes, those of Pakistani ethnicity in Scotland were at increased risk of CVD, whereas Chinese were at lower risk, with these differences unexplained by known risk factors.
authors: Institute of Cardiovascular and Medical Sciences, BHF Glasgow, Cardiovascular Research Centre, University of Glasgow, 126 University Place, G12 8TA, Glasgow, UK.
authors: Muhammad Omar
authors: MO
authors: Malik
authors: L
authors: L
authors: Govan
authors: John R
authors: JR
authors: Petrie
authors: Nazim
authors: N
authors: Ghouri
authors: Graham
authors: G
authors: Leese
authors: Colin
authors: C
authors: Fischbacher
authors: Helen
authors: H
authors: Colhoun
authors: Sam
authors: S
authors: Philip
authors: Sarah
authors: S
authors: Wild
authors: Rory
authors: R
authors: McCrimmon
authors: Naveed
authors: N
authors: Sattar
authors: Robert S
authors: RS
authors: Lindsay
mesh_terms: D000328:Adult; D000368:Aged; D044466:Asian People; D044383:Black People; D002318:Cardiovascular Diseases / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D017691:Caribbean Region / Q000208:ethnology; D002681:China / Q000208:ethnology; D003924:Diabetes Mellitus, Type 2 / Q000175:diagnosis / Q000208:ethnology* / Q000401:mortality; D005260:Female; D005500:Follow-Up Studies; D054624:Health Status Disparities; D006801:Humans; D015994:Incidence; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D010154:Pakistan / Q000208:ethnology; D011379:Prognosis; D016016:Proportional Hazards Models; D044469:Racial Groups; D018570:Risk Assessment; D012307:Risk Factors; D012606:Scotland / Q000453:epidemiology; D013997:Time Factors; D044465:White People