title: Marked differences in cardiovascular risk profiles in middle-aged and older Chinese residents: Evidence from a large Australian cohort.
abstract: BACKGROUND
  Although Chinese form the largest non-English speaking group in Australia, cardiovascular disease (CVD) risk profiles among Chinese Australians have not been comprehensively examined, nor has the effect of mixed-Chinese ethnicity been adequately explored. This study is to investigate cardiovascular risk among Chinese, mixed-Chinese, and non-Chinese Australians.
  
  
  METHODS
  Using data from 266,696 Australian participants from the 45 and Up Study (2006-2009), this study investigated cardiovascular risk among Chinese (n=3454), mixed-Chinese (n=1062), and non-Chinese (n=262,180) participants. Poisson regression models with a robust error variance were used to estimate prevalence ratio (PR) and 95% confidence intervals (CI) for CVD (coronary heart disease (CHD) and stroke) and six major risk factors (hypertension, diabetes, high cholesterol, smoking, overweight/obesity, and physical inactivity) by ethnicity using non-Chinese participants as the reference group. Each outcome was adjusted for sociodemographic characteristics.
  
  
  RESULTS
  Compared with non-Chinese Australians, Chinese had lower prevalence of CHD (PR=0.67; 95% CI=0.59-0.75) and stroke (PR=0.67; 95% CI=0.51-0.88). Of the risk factors, Chinese had higher prevalence of diabetes (PR=1.25; 95% CI=1.12-1.39), smoking (PR=1.22; 95% CI=1.04-1.43) and physical inactivity (PR=1.48; 95% CI=1.41-1.55) but lower prevalence of hypertension (PR=0.90; 95% CI=0.86-0.95), high cholesterol (PR=0.87; 95% CI=0.79-0.95), and overweight/obesity (PR=0.46; 95% CI=0.43-0.48). Mixed-Chinese had higher prevalence of CVD and worse CVD risk profiles compared with Chinese.
  
  
  CONCLUSIONS
  There are marked differences in the prevalence of CVD and risk factors among three groups. The noticeable variations in CVD risk between Chinese and mixed-Chinese indicate that conventional classification of treating all Chinese as homogeneous could be misleading. More investigation into the health outcomes of mixed ancestry is warranted.
authors.affiliation: Sydney Nursing School, University of Sydney, New South Wales, Australia. Electronic address: kjin2224@uni.sydney.edu.au.
authors.forename: Kai
authors.initials: K
authors.lastname: Jin
authors.affiliation: Charles Perkins Centre, Sydney Nursing School, University of Sydney, New South Wales, Australia.
authors.forename: Lis
authors.initials: L
authors.lastname: Neubeck
authors.affiliation: Sydney Nursing School, University of Sydney, and, New South Wales, Australia; Sydney Local Health District, New South Wales, Australia.
authors.forename: Janice
authors.initials: J
authors.lastname: Gullick
authors.affiliation: Sydney Nursing School, University of Sydney, New South Wales, Australia.
authors.forename: Fung
authors.initials: F
authors.lastname: Koo
authors.affiliation: Sydney School of Public Health, University of Sydney, New South Wales, Australia.
authors.forename: Ding
authors.initials: D
authors.lastname: Ding
mesh_terms: D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People / Q000706:statistics & numerical data*; D001315:Australia; D002318:Cardiovascular Diseases / Q000208:ethnology*; D002681:China / Q000208:ethnology; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D012959:Socioeconomic Factors
keywords: Cardiovascular disease (CVD); Cardiovascular risk factors; Chinese immigrants; Secondary prevention