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The Relationship Between Metabolic Risk Factors and Incident Cardiovascular Disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited)— A Prospective Population-Based Study

Journal of the American College of Cardiology, 2013-04, Vol.61 (17), p.1777-1786 [Peer Reviewed Journal]

2014 INIST-CNRS ;Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;2013 Elsevier Inc. 2013 American College of Cardiology Foundation ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2012.12.046 ;PMID: 23500273 ;CODEN: JACCDI

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Title:
The Relationship Between Metabolic Risk Factors and Incident Cardiovascular Disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited)— A Prospective Population-Based Study
Author: TILLIN, Therese ; HUGHES, Alun D ; MAYET, Jamil ; WHINCUP, Peter ; SATTAR, Naveed ; FOROUHI, Nita G ; MCKEIGUE, Paul M ; CHATURVEDI, Nish
Subjects: Acute Coronary Syndrome - blood ; Acute Coronary Syndrome - ethnology ; Adipose Tissue - pathology ; Adult ; Age Factors ; Aged ; Asia, Southeastern ; Asians - statistics & numerical data ; Biological and medical sciences ; Blacks - statistics & numerical data ; Blood Glucose - metabolism ; Body Mass Index ; Cardiology. Vascular system ; Cardiovascular Diseases - blood ; Cardiovascular Diseases - epidemiology ; Cardiovascular Diseases - ethnology ; Cardiovascular Diseases - mortality ; Caribbean Region - ethnology ; Cholesterol, HDL - blood ; Cholesterol, LDL - blood ; Clinical Research ; Coronary Artery Disease - blood ; Coronary Artery Disease - ethnology ; Diabetes Complications - blood ; Diabetes Complications - ethnology ; Dyslipidemias - blood ; Dyslipidemias - complications ; Dyslipidemias - ethnology ; Feeding Behavior ; Female ; Follow-Up Studies ; Glycated Hemoglobin A - metabolism ; Heart ; Humans ; Incidence ; Insulin - blood ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - blood ; Myocardial Infarction - ethnology ; Odds Ratio ; Proportional Hazards Models ; Prospective Studies ; Risk Factors ; Sex Factors ; Smoking - adverse effects ; Stroke - blood ; Stroke - epidemiology ; Stroke - ethnology ; Surveys and Questionnaires ; Triglycerides - blood ; United Kingdom - epidemiology ; Waist-Hip Ratio ; Whites - statistics & numerical data
Is Part Of: Journal of the American College of Cardiology, 2013-04, Vol.61 (17), p.1777-1786
Description: This study sought to determine whether ethnic differences in diabetes, dyslipidemia, and ectopic fat deposition account for ethnic differences in incident cardiovascular disease. Coronary heart disease risks are elevated in South Asians and are lower in African Caribbeans compared with Europeans. These ethnic differences map to lipid patterns and ectopic fat deposition. Cardiovascular risk factors were assessed in 2,049 Europeans, 1,517 South Asians, and 630 African Caribbeans from 1988 through 1991 (mean age: 52.4 ± 6.9 years). Fatal and nonfatal events were captured over a median 20.5-year follow-up. Subhazard ratios (SHR) were calculated using competing risks regression. Baseline diabetes prevalence was more than 3 times greater in South Asians and African Caribbeans than in Europeans. South Asians were more and African Caribbeans were less centrally obese and dyslipidemic than Europeans. Compared with Europeans, coronary heart disease incidence was greater in South Asians and less in African Caribbeans. The age- and sex-adjusted South Asian versus European SHR was 1.70 (95% confidence interval [CI]: 1.52 to 1.91, p < 0.001) and remained significant (1.45, 95% CI: 1.28 to 1.64, p < 0.001) when adjusted for waist-to-hip ratio. The African Caribbean versus European age- and sex-adjusted SHR of 0.64 (95% CI: 0.52 to 0.79, p < 0.001) remained significant when adjusted for high-density lipoprotein and low-density lipoprotein cholesterol (0.74, 95% CI: 0.60 to 0.92, p = 0.008). Compared with Europeans, South Asians and African Caribbeans experienced more strokes (age- and sex-adjusted SHR: 1.45 [95% CI: 1.17 to 1.80, p = 0.001] and 1.50 [95% CI: 1.13 to 2.00, p = 0.005], respectively), and this differential was more marked in those with diabetes (age-adjusted SHR: 1.97 [95% CI: 1.16 to 3.35, p = 0.038 for interaction] and 2.21 [95% CI: 1.14 to 4.30, p = 0.019 for interaction]). Ethnic differences in measured metabolic risk factors did not explain differences in coronary heart disease incidence. The apparently greater association between diabetes and stroke risk in South Asians and African Caribbeans compared with Europeans merits further study.
Publisher: New York, NY: Elsevier
Language: English
Identifier: ISSN: 0735-1097
EISSN: 1558-3597
DOI: 10.1016/j.jacc.2012.12.046
PMID: 23500273
CODEN: JACCDI
Source: GFMER Free Medical Journals
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The Relationship Between Metabolic Risk Factors and Incident Cardiovascular Disease in Europeans, South Asians, and African Caribbeans: SABRE (Southall and Brent Revisited)— A Prospective Population-Based Study

2014 INIST-CNRS ;Copyright © 2013 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved. ;2013 Elsevier Inc. 2013 American College of Cardiology Foundation ;ISSN: 0735-1097 ;EISSN: 1558-3597 ;DOI: 10.1016/j.jacc.2012.12.046 ;PMID: 23500273 ;CODEN: JACCDI

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