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Cardiovascular diseases in Chinese, Malays, and Indians in Singapore. I. Differences in mortality
1National University of Singapore, Department of Community, Occupational and Family Medicine.
Insights
Ethnic differences in cardiovascular disease mortality were significant in Singapore. Indians showed higher ischaemic heart disease rates, while Malays had higher hypertensive disease mortality.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Disease Research
Background:
- Cardiovascular diseases (CVDs) pose a significant global health burden.
- Understanding ethnic variations in CVD mortality is crucial for targeted public health interventions.
- Singapore's multi-ethnic population provides a unique setting to study these differences.
Purpose of the Study:
- To analyze and compare mortality rates from major cardiovascular diseases (ischaemic heart disease, hypertensive disease, cerebrovascular disease) across Chinese, Malay, and Indian ethnic groups in Singapore.
- To identify specific ethnic disparities in CVD mortality within a defined population.
Main Methods:
- Utilized national death registration data from Singapore for the period 1980-1984.
- Analyzed underlying causes of death, coded according to the International Classification of Diseases (9th revision).
- Focused on deaths within the 30-69 year age range, stratified by ethnicity.
Main Results:
- Indians exhibited significantly higher mortality from ischaemic heart disease compared to Chinese and Malays.
- Malays demonstrated the highest mortality rates for hypertensive disease across both sexes.
- Cerebrovascular disease mortality showed minimal ethnic variation, with slightly lower rates observed in Chinese females.
Conclusions:
- Significant ethnic disparities exist in mortality patterns for major cardiovascular diseases in Singapore.
- These findings underscore the importance of considering ethnicity in CVD prevention and management strategies.
- Further research into the underlying factors contributing to these ethnic differences is warranted.
Study Objective:
The aim of the study was to analyse differences in mortality from the main cardiovascular diseases (ischaemic heart disease, hypertensive disease, and cerebrovascular disease) among Chinese, Malays, and Indians in Singapore.
Design:
The study was a survey using national death registration data in Singapore for the five years 1980 to 1984. The underlying cause of death, coded according to the ninth revision of the International Classification of Diseases, was taken for the analyses.
Setting:
The study was confined to the independent island state of Singapore, population 2.53 million (Chinese 76.5%, Malays 14.8%, Indians 6.4%, Others 2.3%). Death registration is thought to be complete.
Subjects:
All registered deaths in the age range 30-69 years during the study period were analysed by ethnic group.
Measurement And Main Results:
Indians had higher mortality from ischaemic heart disease than the other ethnic groups in both sexes, with age-standardised relative risks of Indian v Chinese (males 3.8, females 3.4), Indian v Malay (males 1.9, females 1.6), and Malay v Chinese (males 2.0, females 2.2). The excess mortality in Indians declined with age. For hypertensive disease Malays had the highest mortality, with age-standardised relative risks of Malay v Chinese (males 3.4, females 4.4), Malay v Indian (males 2.0, females 2.5), and Indian v Chinese (males 1.6, females 1.6). For cerebrovascular disease there was little ethnic difference except for lower rates in Chinese females, with age-standardised relative risks of Malay v Chinese (males 1.1, females 1.9), Malay v Indian (males 1.0, females 1.1), and Indian v Chinese (males 1.1, females 1.7).
Conclusions:
There are significant differences in mortality from the three main cardiovascular diseases in the different ethnic groups in Singapore.