Mortality from coronary heart disease (CHD), stroke and and hypercholesterolaemia are less prevalent in ethnic minority populations in the United Kingdom and unlikely end-stage renal failure are high in South Asian migrants in the UK. This is associated with high prevalence of to explain the differences seen between groups, although each risk factor is likely to contribute to the diabetes and hypertension. These seem to be manifestations of a metabolic syndrome with insulin resistance variation in vascular disease within each group. There is difficulty in reconciling the results of (hyperinsulinaemia) and central obesity (based on high waist-to-hip ratio rather than on conventional measures migration studies (eg, from rural to urban environments) pointing to major environmental influences on the of body mass index). This is associated with sedentary lifestyle, high serum triglycerides and low HDL-choleschanges in cardiovascular risk factors with the consistent pattern of disease of ethnic groups across the world terol.Mortality from stroke and end-stage renal failure are and in subsequent generations, suggesting a certain degree of genetic susceptibility. Important environmenthigh in black migrants to the UK (both Caribbeans and West Africans). However, CHD mortality is low in this gene interplays might be underlying some of these processes. group. This pattern of mortality is associated with high prevalence of hypertension and diabetes. This groupThe detection and management of hypertension and diabetes are still unsatisfactory in inner city areas and tends to be obese (particularly women) according to conventional measures of body mass index and to have show variations by ethnic origin. Strategies for the control of CHD and stroke adopted in European countries hyperinsulinaemia, low serum triglycerides and high HDL-cholesterol. directed mostly to white populations may be inappropriate for ethnic minority populations. Conventional risk factors such as cigarette smoking