Coronary risk in a British Punjabi population: comparative profile of non-biochemical factors

To develop a profile of non-biochemical coronary risks for the South Asian population (predominantly Punjabi with origins in the Indian subcontinent) and the general population in Glasgow, with a focus on dietary patterns, and potential causes of stress.

Cross-sectional survey of South Asian men and women of 30-40 years (mean 35), compared with a general population sample aged 35 years.

Data were collected on socioeconomic circumstances, smoking, diet, alcohol, exercise, past health, perceptions of stress and other psychological morbidity, blood pressure, height, weight and waist and hip girth.

The socioeconomic circumstances of the South Asian group were worse than the general population. The prevalence of several circumstances potentially associated with stress, such as length of working day, low income, crowded housing, liability to attack and perceived lack of social support (women), was greater in South Asians. Smoking was less common in South Asians, particularly among women and non-Muslims. Amongst South Asians, alcohol use was uncommon in women and Muslims. South Asians ate meat, and fruit, salad and raw vegetables more frequently than the general population though there were large variations by religion. South Asian men were less likely to take vigorous exercise than the general population. Diastolic, but not systolic, blood pressure was higher in South Asian males than general population males, but there were no differences among women. Men were shorter and weighed less than general population men, with no difference in body mass index. South Asian women were shorter but had higher mean body mass index than the general population. Waist and hip circumference in both South Asian men and women were higher although waist/hip ratios were not different. Self-reported diabetes was commoner in Asian men than in general population men, and angina symptoms commoner in South Asian women.

Among established risk factors studied here or reported in an earlier paper the only one to which South Asians had less exposure was smoking. In either men or women (or both) there was a relative excess of the other known risk factors. There was evidence in support of three newer hypotheses for the high incidence of coronary heart disease (CHD), namely, insulin resistance, stress, and socioeconomic deprivation. The high CHD rates in South Asians are likely to result from a complex interaction of risk factors.