Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London
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Published on: September 26, 2018
F P Cappuccio1, D G Cook, R W Atkinson
1Department of Medicine, St George's Hospital Medical School, London, UK. f.cappuccio@sghms.ac.uk
Insights
Cardiovascular risk factors like hypertension and diabetes are significantly higher in ethnic minorities in Britain. While detection and management have improved, disparities persist, necessitating culturally sensitive health strategies.
Area of Science:
- Public Health
- Epidemiology
- Vascular Medicine
Background:
- Cardiovascular diseases remain a leading cause of mortality globally.
- Ethnic disparities in health outcomes are well-documented but require specific investigation within diverse populations.
- Understanding the prevalence and management of cardiovascular risk factors across different ethnic groups is crucial for targeted public health interventions.
Purpose of the Study:
- To determine the prevalence of key cardiovascular risk factors (hypertension, diabetes, obesity, high cholesterol, smoking) in three distinct ethnic groups.
- To evaluate the extent of detection and effectiveness of management for these risk factors within these groups.
- To identify ethnic variations in the burden and control of cardiovascular disease risk.
Main Methods:
- A population-based survey conducted between 1994 and 1996 in South London.
- Inclusion of 1578 men and women aged 40-59 years from White, African, and South Asian ethnic backgrounds.
- Assessment of age-adjusted prevalence for hypertension, diabetes, obesity, raised serum cholesterol, and smoking.
Main Results:
- Ethnic minorities, particularly those of African and South Asian descent, exhibited significantly higher prevalence rates of hypertension and diabetes compared to White individuals.
- Severe obesity was notably high, especially among women of African descent.
- White individuals showed higher rates of raised serum cholesterol and smoking.
- While detection of hypertension improved, adequate blood pressure control and management varied across ethnic groups, with those of African descent being more likely detected but less likely adequately managed.
Conclusions:
- Hypertension and diabetes prevalence are two- to threefold higher in South Asian, Caribbean, and West African populations residing in Britain.
- Despite improvements, ethnic disparities in hypertension detection, management, and control persist.
- Obesity levels exceed national targets across all studied ethnic groups, with a pronounced prevalence in women of African descent.
- Tailored preventive and treatment strategies are essential, considering cultural factors and ethnic-specific susceptibilities to vascular diseases.
Objective:
To assess the prevalence of cardiovascular risk factors and their level of detection and management in three ethnic groups.
Design:
Population based survey during 1994 to 1996.
Setting:
Former Wandsworth Health Authority in South London.
Subjects:
1578 men and women, aged 40 to 59 years; 524 white, 549 of African descent, and 505 of South Asian origin.
Main Outcome Measures:
Age adjusted prevalence of hypertension, diabetes, obesity, raised serum cholesterol, and smoking.
Results:
Ethnic minorities of both sexes had raised prevalence rates of hypertension and diabetes compared to white people. Age and sex standardised prevalence ratios for hypertension were 2.6 (95% confidence interval 2.1 to 3.2) in people of African descent and 1.8 (1.4 to 2.3) in those of South Asian origin. For diabetes, the ratios were 2.7 (1.8 to 4.0) in people of African descent and 3.8 (2.6 to 5.6) in those of South Asian origin. Hypertension and diabetes were equally common among Caribbeans and West Africans and among South Asian Hindus and Muslims. Prevalence of severe obesity was high overall, but particularly among women of African descent (40% (35% to 45%)). In contrast, raised serum cholesterol and smoking rates were higher among white people. Of hypertensives, 49% (216 of 442) had adequate blood pressure control. Overall, 18% (80 of 442) of hypertensives and 33% (62 of 188) of diabetics were undetected before our survey. Hypertensive subjects of African descent appeared more likely to have been detected (p = 0.034) but less likely to be adequately managed (p = 0.085).
Conclusions:
Hypertension and diabetes are raised two- to threefold in South Asians, Caribbeans, and West Africans in Britain. Detection, management, and control of hypertension has improved, but there are still differences between ethnic groups. Obesity is above the Health of the Nation targets in all ethnic groups, particularly in women of African descent. Preventive and treatment strategies for different ethnic groups in Britain need to consider both cultural differences and underlying susceptibility to different vascular diseases.
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