scholarly journals Determinants of behavioural and biological risk factors for cardiovascular diseases from state level STEPS survey (2017–19) in Madhya Pradesh

PeerJ ◽  
2020 ◽  
Vol 8 ◽  
pp. e10476
Author(s):  
Arun M. Kokane ◽  
Rajnish Joshi ◽  
Ashwin Kotnis ◽  
Anirban Chatterjee ◽  
Kriti Yadav ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Physical Inactivity ◽  
Alcohol Intake ◽  
Formal Education ◽  
Madhya Pradesh ◽  
Epidemiological Transition ◽  
Cvd Risk Factors ◽  
Cvd Risk

Background National and statewide assessment of cardiovascular risk factors needs to be conducted periodically in order to inform public health policy and prioritise allocation of funds, especially in LMICs. Although there have been studies from India which have explored the determinants of cardiovascular risk factors, they have mostly been from high epidemiological transition states. The present study assessed the determinants of cardiovascular (CVD) risk factors in a low epidemiological transition state (Madhya Pradesh) using the WHO STEPwise approach to surveillance (STEPS). Methods A total of 5,680 persons aged 18–69 years were selected from the state of Madhya Pradesh through multi-stage cluster random sampling. Key CVD risk factors we sought to evaluate were from behavioural (tobacco, alcohol, physical activity, diet) and biological domains (overweight or obese, Hypertension, Diabetes, and Raised serum cholesterol). Key socio-demographic factors of interest were the caste and tribe groups, and rural vs urban location, in addition to known influencers of CVD risk such as age, gender and education level Results Those belonging to the scheduled tribes were more at risk of consuming tobacco (OR 2.13 (95% CI [1.52–2.98]), and a diet with less than five servings of fruits and vegetables (OR 2.78 (95% CI [1.06–7.24]), but had had the least risk of physical inactivity (OR 0.31 (95% CI [0.02–0.54]). Residence in a rural area also reduced the odds of physical inactivity (OR 0.65 (95% CI [0.46–0.92])). Lack of formal education was a risk factor for both tobacco consumption and alcohol intake (OR 1.40 (95% CI [1.08–1.82]) for tobacco use; 1.68 (95% CI [1.14–2.49]) for alcohol intake). Those belonging to schedules tribes had much lower risk of being obese (OR 0.25; 95% CI [0.17–0.37]), but were at similar risk of all other clinical CVD risk factors as compared to other caste groups. Conclusion In the current study we explored socio-demographic determinants of behavioural and biological CVD risks, and found that in Madhya Pradesh, belonging to a scheduled tribe or living in a rural location, protects against being physically inactive or being overweight or obese. Increasing age confers a greater CVD-risk in all domains. Being a male, and lack of formal education confers a greater risk for behavioural domains, but not for most clinical risk domains. Future efforts at curbing CVDs should be therefore two pronged –a population-based strategy targeting biological risk factors, and a more focussed approach directed at those displaying risky behaviour.

scholarly journals Changes to cardiovascular risk factors over 7 years: a prospective cohort study of in situ urbanised residents in the Chaoyang District of Beijing

BMJ Open ◽  
2020 ◽  
Vol 10 (3) ◽  
pp. e033548
Author(s):  
Zhe Li ◽  
Shicheng Yu ◽  
Xiaoyan Han ◽  
Jianjun Liu ◽  
Hongyan Yao
Keyword(s):  
Risk Factors ◽  
Blood Pressure ◽  
Cohort Study ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Overweight And Obesity ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Rural Residents

ObjectivesTo examine changes in cardiovascular risk factors of in situ urbanised residents between 2010 and 2017.DesignPopulation-based cohort study.SettingThe Chaoyang District of Beijing, China.ParticipantsA total of 942 in situ urbanised rural residents aged 35–64 who participated in the cardiovascular disease (CVD) risk factors study in China between 2010 and 2017.Main outcome measuresLifestyles (smoking, drinking and effective exercise) and medical history (diabetes, hypertension, dyslipidaemia, overweight and obesity) were self-reported. New cases of diabetes, hypertension, dyslipidaemia, overweight and obesity were confirmed by physical examination or blood biochemical tests. Multiple linear regression and log-binomial models analyses adjusted for sociodemographic confounders were conducted to evaluate any changes of clinical indexes and to estimate prevalence rate ratios (PRRs), respectively.ResultsDuring the study period of 2010–2017, diastolic blood pressure elevated by 3.55 mm Hg, central blood pressure increased by 4.39 mm Hg, total cholesterol decreased by 0.29 mmol/L and hypertension increased significantly (PRR=1.25, p<0.05) after adjusting for demographic, lifestyle and family history factors. Effective exercise rate (PRR=1.57), prevalence of diabetes (PRR=1.36) and dyslipidaemia (PRR=1.19) all increased from 2010 to 2017. However, these changes were not significant after adjusting for confounders (p>0.05). Prevalence of smoking, drinking, hypertension, overweight and obesity was significantly higher in males than females in both 2010 and 2017. In 2017, the 10-year risk of atherosclerotic CVD increased in 29.8% of participants and decreased in 6.1% of individuals.ConclusionsCVD risk factors augmented remarkably for in situ urbanised rural residents aged 35–64 in the Chaoyang District of Beijing, especially those indicators related to blood pressure. Awareness of the direction and magnitude of these risk factor changes may be beneficial in informing targeted strategies for preventing CVDs of in situ urbanised populations.

scholarly journals Clinical characterization, cardiovascular risk factor profile and cardiac strain analysis in a Uganda cancer population: The SATRACD study

PLoS ONE ◽  
2021 ◽  
Vol 16 (4) ◽  
pp. e0249717
Author(s):  
Wanzhu Zhang ◽  
Feriel Azibani ◽  
Emmy Okello ◽  
James Kayima ◽  
Isaac Sinabulya ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Cancer Patients ◽  
Left Ventricular ◽  
Left Ventricular Ejection ◽  
Qtc Interval ◽  
Cvd Risk Factors ◽  
Cvd Risk

Background The link between cancer and cardiovascular disease is firmly established. We sought to investigate the prevalence of cardiovascular disease (CVD) risk factors in Uganda cancer patients, their pre-chemotherapy left ventricular strain echocardiographic pattern and its associations with the CVD risk factors. Methods and results Baseline pre-chemotherapy data of patients who were enrolled in the SATRACD study (a cancer cohort, who were planned for anthracycline therapy), were analyzed. The prevalence of cardiovascular risk factors and baseline strain echocardiographic images were assessed. Among the 355 patients who were recruited over a period of 15 months, 283 (79.7%) were female, with a mean age of 43 years. The types of cancer of the study patients included breast cancer (70.6%), lymphomas, sarcomas, leukemias and hepatocellular carcinoma. Hypertension was the most common comorbidity (27.0%). The prevalence of obesity was 12.1% and that of HIV was 18.3%. All patients had a normal left ventricular ejection fraction (LVEF). The mean global longitudinal strain (GLS) was -20.92 ±2.43%, with females having a significantly higher GLS than males (-21.09±2.42 vs -20.25±2.39, p = 0.008). Fifty-three patients (14.9%) had suboptimal GLS (absolute GLS≤18.00%), which was associated with obesity (POR = 3.07; 95% CI, 1.31–6.98; p = 0.003), alcohol use (POR = 1.94; 95% CI, 1.01–3.74; p = 0.044), long QTc interval in electrocardiogram (POR = 2.54; 95% CI, 1.06–5.74; p = 0.015,) and impaired left ventricular relaxation (POR = 2.24; 95% CI, 1.17–4.25; p = 0.007). On multivariable logistic regression analysis, obesity (POR = 2.95; 95% CI, 1.24–7.03; p = 0.014) was the only independent factor associated with suboptimal GLS. Conclusion There is high prevalence and a unique pattern of cardiovascular risk factors in Uganda cancer patients. In cancer patients with cardiovascular risk conditions, there is reduction in GLS despite preserved LVEF. Longitudinal research is needed to study the predictive value of cardiovascular risk factors and baseline GLS for post chemotherapy cardiac dysfunction.

scholarly journals Cardiovascular risk factors from diagnosis in children with type 1 diabetes mellitus: a longitudinal cohort study

2019 ◽  
Vol 7 (1) ◽  
pp. e000625 ◽  
Author(s):  
Stephanie Jones ◽  
Amal R Khanolkar ◽  
Evelien Gevers ◽  
Terence Stephenson ◽  
Rakesh Amin
Keyword(s):  
Risk Factors ◽  
Type 1 Diabetes ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Density Lipoprotein ◽  
Diabetes Duration ◽  
Lipoprotein Cholesterol ◽  
Cvd Risk Factors ◽  
Cvd Risk

BackgroundFor childhood onset type 1 diabetes (T1D), the pathogenesis of atherosclerosis is greatly accelerated and results in early cardiovascular disease (CVD) and increased mortality. However, cardioprotective interventions in this age group are not routinely undertaken.AimsTo document prevalence of cardiovascular risk factors from diagnosis of childhood T1D and their relationship with disease duration and ethnicity.MethodsRoutinely collected clinical records for 565 children with T1D were retrospectively analyzed. Data were collected from diagnosis and at routine check-ups at pediatric diabetes clinics across Barts Health National Health Service Trust. Age at diagnosis was 8.5 years (0.9–19.4). Mean follow-up 4.3 years (0–10.8). 48% were boys and 60% were non-white. Linear longitudinal mixed effects models were used to evaluate relationships between risk factors and diabetes duration.ResultsCVD risk factors were present at first screening; 33.8% of children were overweight or obese, 20.5% were hypertensive (elevated diastolic blood pressure (BP)) and total cholesterol, low-density lipoprotein-cholesterol and high-density lipoprotein-cholesterol were abnormal in 63.5%, 34.2% and 22.0%, respectively. Significant associations between diabetes duration and annual increases of body mass index (0.6 kg/m2), BP (0.1 SD score) and lipids (0.02–0.06 mmol/L) were noted. Annual increases were significantly higher in black children for BP and Bangladeshi children for lipids. Bangladeshi children also had greatest baseline levels.ConclusionsCVD risk factors are present in up to 60% of children at diagnosis of T1D and increase in prevalence during the early years of the disease. Commencing screening in younger children and prioritizing appropriate advice and attention to ethnic variation when calculating risk should be considered.

scholarly journals Does transition through menopause affect cardiovascular disease risk factors? Results from a population-based cohort (CoLaus study)

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
P F Raguindin ◽  
I Cardona ◽  
T Muka ◽  
I Lambrinoudaki ◽  
C Gebhard ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Mixed Models ◽  
Premenopausal Women ◽  
Population Based ◽  
Risk Profile ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Introduction Menopause has been associated with adverse cardiovascular disease (CVD) risk profile, yet it is unclear whether the changes in CVD risk factors differ by reproductive stage independently of underlying aging trajectories. We examined whether reproductive stages are differently associated with changes in cardiovascular risk factors. Methods This is a prospective population-based cohort study. We used data from women at baseline and follow-up (mean 5.5 years). We classified women into (i) premenopausal, (ii) menopausal transition, (iii) early (≤5 years), and (iv) late (&gt;5 years) postmenopausal by comparing their menstruation status at baseline and follow-up. In the cross-sectional analysis, we compared CVD risk factors at baseline across different reproductive stages using multivariable linear regression models. In the longitudinal analysis, we used multivariable linear mixed models. We used premenopausal women as a reference category and adjusted our analyses for age, medications, hormone replacement therapy, lifestyle, body mass index (BMI) at baseline and follow-up. Results We used the data from 2,558 women aged 35–75 years. At baseline, compared to premenopausal women, (i) transition and early postmenopausal groups had higher HDL, (ii) early- and late postmenopausal women had higher BMI, total cholesterol, adiponectin, and interleukin-6 levels, and (iii) all other women groups had higher diastolic blood pressure and glucose levels, while no differences were observed in the other CVD risk factors. At follow-up, women across the four reproductive categories showed an increase in BMI, total cholesterol, triglycerides, and fasting glucose compared to baseline. However, linear mixed models showed that, the changes in CVD risk factors were not significantly different in the other three menopausal categories compared to premenopausal women. When using age as a predictor variable and adjusting for menopause status, most of the CVD risk factors increased, while interleukin 6 and interleukin 1b decreased with advancing age. The estimates did not change when the analyses were restricted to women who did not report hormone therapy-use. Conclusion The current study suggests that women have a worsening of cardiovascular risk profile as they age, and although menopausal women may have higher levels of cardiovascular risk factors compared to premenopausal women at any given time, the five year changes in cardiovascular risk factors may not depend on menopausal status per se. More studies are still needed to disentangle the contribution of age and menopause in postmenopausal CVD risk, and other pathways not explored in this study. FUNDunding Acknowledgement Type of funding sources: Other. Main funding source(s): COLAUS was supported by a research grants from GlaxoSmithKline and the Swiss National Science Foundation and

scholarly journals Relationship between cardiovascular risk factors and adipocytokines gene expression in local fat depots

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
Y U A Dyleva ◽  
O V Gruzdeva ◽  
E V Belik ◽  
M Y U Sinitsky ◽  
A V Sotnikov ◽  
...  
Keyword(s):  
Gene Expression ◽  
Risk Factors ◽  
Blood Pressure ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Lipid Lowering ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Fat Depots ◽  
Lepr Expression

Abstract   In this study we studied the relationships between adipokines (leptin, soluble leptin receptor) in adipose tissue (AT) and cardiovascular disease (CVD) risk factors. Methods Fat tissue biopsies were obtained from 134 patients median aged 64.0 (48.0; 68.0) with stable CAD undergoing coronary artery bypass grafting. Traditional cardiovascular risk factors and patient treatment have been recorded. AH was defined as systolic blood pressure &gt;140 mm Hg Art., diastolic blood pressure &gt;90 mm Hg. Dyslipidemia was defined as a previously detected increase in total serum cholesterol (&gt;200 mg/dl), triglycerides (&gt;200 mg/dl), or low-density lipoprotein (LDL) cholesterol (&gt;150 mg/dl) for at least 1 year, or use of lipid-lowering drugs. Smoking was classified as current or former smokers; current smoking status was defined as at least one cigarette daily over the last year. Adipocytes were isolated from subcutaneous (SAT), epicardial (EAT), and perivascular AT (PVAT) samples. Isolated adipocytes were cultured for 24-h after which, Then adipocytes were immediately processed to RNA extraction and determination of adipokines gene expression. Results In this study, we showed that men with CAD LEP and LEPR expression were lower in PVAT, whereas only the latter was decreased in SAT. Thus, LEPR expression in local fat depots appeared to differ in men and women, which is consistent with previous reports. Men with CAD showed lower LEP expression than women in EAT, whereas no significant differences were observed in SAT. Patients 51–59 years old were characterized by the lowest LEP expression in SAT and the highest LEP and LEPR expression in EAT and PVAT. Those &gt;60 years presented the highest levels of LEPR in SAT. The presence of dyslipidemia in patients with CAD correlated with decreased LEPR expression in EAT, which is an unfavorable sign and may potentially lead to the development of leptin resistance. In patients with AH, LEP expression in EAT and LEPR expression in SAT and PVAT is increased. AH &gt;20 years was associated with increased LEP in ATs. Smokers with CAD exhibited higher levels of LEP expression in SAT and EAT, and LEPR expression in SAT. Conclusions The results of the study indicate a close association of traditional CVD risk factors with adipocytokine imbalance in patients with CAD. The results indicate the potential of the fat depot and leptin and its receptor data as a drug application point. The study of the molecular basis of PVAT and EAT function can provide a more complete understanding of the etiopathogenetic mechanisms of CVD and develop an effective strategy for their prevention and control. FUNDunding Acknowledgement Type of funding sources: None.

scholarly journals Body Mass Index Predicts Cardiovascular Risk Factors and Inflammatory Status in Postmenopausal Women

2021 ◽  
Vol 5 (Supplement_2) ◽  
pp. 1249-1249
Author(s):  
Saiful Singar ◽  
Richard Suminski ◽  
Bahram Arjmandi ◽  
Shirin Hooshmand ◽  
Sheau Chai
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Postmenopausal Women ◽  
Body Mass ◽  
Fasting Glucose ◽  
Bone Biomarkers ◽  
Cvd Risk Factors ◽  
Cvd Risk

Abstract Objectives Some studies have shown that hormonal changes during menopause transition may lead to weight gain. Higher body mass index (BMI) may be beneficial for bone health but not for heart health. However, these phenomena are still unclear. The present study aimed to determine whether BMI is associated with cardiovascular risk factors, and bone and inflammatory biomarkers in osteopenic postmenopausal women. Methods In a cross-sectional study, 132 healthy osteopenic postmenopausal women (1 to 10 years) not on hormone therapy (HT) and other pharmacological agents known to affect bone were recruited. Overnight fasting blood and urine samples were collected. Multiple linear regression analyses were conducted to examine the associations between BMI and changes in CVD risk factors and inflammatory and bone biomarkers. Results Higher BMI was significantly associated with elevated serum fasting glucose, C-reactive protein (CRP), apolipoprotein B (ApoB), total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), and triglycerides (TG) levels after controlling for age, years of menopause, physical activity level, and total energy intake. Based on the regression model, every one unit increase in BMI was predicted to increase fasting glucose, CRP, ApoB, TC, LDL, TG by 1.0 mg/dL, 0.1 mg/L, 1.6 mg/dL, 2.8 mg/dL, 3.2 mg/dL, and 3.3 mg/dL, respectively. BMI was not associated with bone formation and resorption biomarkers. Conclusions BMI is a good predictor of inflammatory marker and CVD risk factors but not bone biomarkers in postmenopausal women. Future studies are needed to examine the associations of body composition (lean mass and fat mass) on CVD risk factors and bone biomarkers. Funding Sources N/A.

scholarly journals Prevalence of Cardiovascular Risk Factors in the Middle-Aged and Elderly Population of a Nigerian Rural Community

2011 ◽  
Vol 2011 ◽  
pp. 1-6 ◽  
Author(s):  
E. C. Ejim ◽  
C. I. Okafor ◽  
A. Emehel ◽  
A. U. Mbah ◽  
U. Onyia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Rural Community ◽  
Urban Areas ◽  
Cvd Risk Factors ◽  
African Countries ◽  
Cvd Risk ◽  
Cross Sectional ◽  
Mortality And Morbidity

Cardiovascular diseases (CVDs) causes of worldwide preventable morbidity and mortality. CVDs are a leading cause of mortality and morbidity in developing countries, and rates are expected to rise over the next few decades. The prevalence of CVD risk factors is dramatically increasing in low-and middle-income African countries, particularly in urban areas. We carried out a cross-sectional population-based survey in Imezi-Owa, a rural community in South East Nigeria to estimate the prevalence of major cardiovascular risk factors in both men and women aged 40–70 years. A total of 858 individuals made up of 247 (28.8%) males and 611 (71.2%) females were recruited. The mean age of the subjects was59.8±9.9years. The prevalence of the different cardiovascular risk factors among the 858 subjects was as follows: hypertension 398 (46.4%) subjects, generalized obesity as determined by BMI 257 (30%) subjects, abdominal obesity 266 (31%) subjects, dysglycaemia 38 (4.4%) subjects and hypercholesterolaemia 32 (3.7%) subjects. Prevalence of hypertension and dysglycaemia was higher in men while the others were higher in women. Only hypertension (P=.117) and hypercholesterolaemia (P=.183) did not reveal any significant association with gender. Prevalence of CVD risk factors was highest in subjects aged 65 to 70 years.

scholarly journals Awareness of cardiovascular risk factors among university students in Turkey

2019 ◽  
Vol 20 ◽  
Author(s):  
F. Esra Güneş ◽  
Nural Bekiroglu ◽  
Neşe Imeryuz ◽  
Mehmet Agirbasli
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
University Students ◽  
Cardiovascular Risk Factors ◽  
Primary Healthcare ◽  
Healthcare Workers ◽  
Risk Level ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Unhealthy Diet

Abstract Aim: To determine the awareness of cardiovascular risk factors among university students in Turkey. Background: Cardiovascular disease (CVD) is the leading cause of death in developed countries. The use of tobacco products and unhealthy diet are prominent habits that increase the risk of CVD. Methods: Healthy university students (n = 2450) aged between 18 and 22 years in Istanbul filled out the questionnaire about the awareness of CVD risk factors and participated in this cross-sectional study. They were asked several questions with regard to the importance of CVD risk factors. Findings: The leading responses for men and women were, respectively, high cholesterol (58.3; 72.3%), stress (58.8; 71.8%), hypertension (50; 64.2%), smoking (53.1; 58.7%), obesity (46.8; 64.3%), diabetes (41.7; 52.7%), inactivity (43.3; 47.8%), and CVD in family history (31.8; 44.4%). Unhealthy diet (9.7; 15.3%), exposure to second-hand cigarette smoking (24.4; 34%), and poor socioeconomic status (22.6; 22.3%) were also considered to be important. The study also revealed that men disregard the risk factors more frequently. Another comparison between body mass index groups revealed that obese subjects gave significantly lower importance to cardiovascular risk factors. Conclusion: Observations indicate that awareness levels of CVD risk factors have to be improved among university students. It is emphasized that primary healthcare workers are very important in the screening of CVD risk factors in an opportunistic and systematic way and in providing consultancy on changing risky behaviors (diet, smoking, etc.). Therefore, it is of utmost importance that primary healthcare workers make interventions to reduce the risk level by determining the CVD risk.

scholarly journals Educational differences in cardiovascular mortality: The role of shared family factors and cardiovascular risk factors

2016 ◽  
Vol 44 (8) ◽  
pp. 744-750 ◽  
Author(s):  
M. K. R. Kjøllesdal ◽  
I. Ariansen ◽  
L. H. Mortensen ◽  
G. Davey Smith ◽  
Ø. Næss
Keyword(s):  
Risk Factors ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
Family Factors ◽  
Cvd Risk Factors ◽  
Cvd Risk ◽  
Educational Group ◽  
Educational Differences ◽  
Family Based ◽  
Cvd Mortality

Aims: To explore the confounding effects of early family factors shared by siblings and cardiovascular risk factors in midlife on the educational differences in mortality from cardiovascular disease (CVD). Methods: Data from national and regional health surveys in Norway (1974–2003) were linked with data from the Norwegian Family Based Life Course Study, the National Educational Registry and the Cause of Death Registry. The study population consisted of participants with at least one full sibling among the health survey participants ( n=271,310). Data were available on CVD risk factors, including weight, height, blood pressure, total cholesterol and smoking. Results: The hazards ratio (HR) of CVD mortality was 3.44 (95% confidence interval (CI) 2.98–3.96) in the lowest educational group relative to the highest. The HRs were little altered in the within-sibship analyses. Adjusted for risk factors, the HR for CVD mortality in the cohort analyses was 2.05 (CI 1.77–2.37) in the lowest educational group relative to the highest. The respective HR in the within-sibship analyses was 2.46 (CI 1.48–2.24). Conclusions: Using a sibling design, we did not find that the association between education and CVD mortality was confounded by early life factors shared by siblings, but it was explained to a large extent by CVD risk factors. These results suggest that reducing levels of CVD risk factors could have the greatest effect on mortality in less well-educated people.

South Asians and Anglo Australians with heart disease in Australia

2015 ◽  
Vol 39 (5) ◽  
pp. 568 ◽  
Author(s):  
Sabrina Gupta ◽  
Rosalie Aroni ◽  
Siobhan Lockwood ◽  
Indra Jayasuriya ◽  
Helena Teede
Keyword(s):  
Risk Factors ◽  
Type 2 Diabetes ◽  
Heart Disease ◽  
Cardiovascular Risk ◽  
Cardiovascular Risk Factors ◽  
South Asians ◽  
Gensini Score ◽  
Cvd Risk Factors ◽  
Cvd Risk

Objectives The aim of the present study was to determine cardiovascular disease (CVD) risk factors and compare presentation and severity of ischaemic heart disease (IHD) among South Asians (SAs) and Anglo Australians (AAs). Methods A retrospective clinical case audit was conducted at a public tertiary hospital. The study population included SA and AA patients hospitalised for IHD. Baseline characteristics, evidence of diabetes and other CVD risk factors were recorded. Angiography data were also included to determine severity, and these were assessed using a modified Gensini score. Results SAs had lower mean (± s.d.) age of IHD presentation that AAs (52 ± 9 vs 55 ± 9 years, respectively; P = 0.02), as well as a lower average body mass index (BMI; 26 ± 4 vs 29 ± 6 kg/m2, respectively; P = 0.005), but a higher prevalence of type 2 diabetes (57% vs 31%, respectively; P = 0.001). No significant differences were found in coronary angiography parameters. There were no significant differences in the median (interquartile range) Gensini score between SAs and AAs (43.5 (27–75) vs 44 (26.5–68.5), respectively), median vessel score (1 (1–2) vs 2 (1–3), respectively) or multivessel score (37% (33/89) vs 54% (22/41), respectively). Conclusions The findings show that in those with established IHD, cardiovascular risk factors, such as age at onset and BMI, differ between SAs and AAs and these differences should be considered in the prevention and management of IHD. What is known about the topic? There is much evidence on CVD and SAs, it being a leading cause of mortality and morbidity for this population both in their home countries and in countries they have migrated to. Studies conducted in Western nations other than Australia have suggested a difference in the risk profiles and presentations of CVD among SA migrants compared with the host populations in developed countries. Although this pattern of cardiovascular risk factors among SAs has been well documented, there is insufficient knowledge about this population, currently the largest population of incoming migrants, and CVD in the Australian setting. What does this paper add? This paper confirms that a similar pattern of CVD exists in Australia among SAs as does in other Western nations they have migrated to. The CVD pattern found in this population is that of an earlier age of onset at lower BMI compared with the host AA population, as well as a differing cardiovascular risk profile, with higher rates of type 2 diabetes and lower smoking rates. In addition, this study finds similar angiographic results for both the SAs and AAs; however, the SAs exhibit these similar angiographic patterns at younger ages. What are the implications for practitioners? SAs in Australia represent a high cardiovascular risk group and should be targeted for more aggressive screening at younger ages. Appropriate preventative strategies should also be considered bearing in mind the differing risk factors for this population, namely low BMI and high rates of type 2 diabetes. More intensive treatment strategies should also be regarded by practitioners. Importantly, both policy makers and health professionals must consider that all these strategies should be culturally targeted and tailored to this population and not assume a ‘one-size fits all’ approach.

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