Heterogeneity of coronary heart disease risk factors in Indian, Pakistani, Bangladeshi, and European origin populations: cross sectional study

Abstract

Objective To compare coronary risk factors and disease prevalence among Indians, Pakistanis, and Bangladeshis, and in all South Asians (these three groups together) with Europeans. Results There were differences in social and economic circumstances, lifestyles, anthropometric measures and disease both between Indians, Pakistanis, and Bangladeshis and between all South Asians and Europeans. Bangladeshis and Pakistanis were the poorest groups. For most risk factors, the Bangladeshis (particularly men) fared the worst: smoking was most common (57%) in that group, and Bangladeshis had the highest concentrations of triglycerides (2.04 mmol/l) and fasting blood glucose (6.6 mmol/l) and the lowest concentration of high density lipoprotein cholesterol (0.97 mmol/l). Blood pressure, however, was lowest in Bangladeshis. Bangladeshis were the shortest (men 164 cm tall v 170 cm for Indians and 174 cm for Europeans). A higher proportion of Pakistani and Bangladeshi men had diabetes (22.4% and 26.6% respectively) than Indians (15.2%). Comparisons of all South Asians with Europeans hid some important differences, but South Asians were still disadvantaged in a wide range of risk factors. Findings in women were similar. Conclusion Risk of coronary heart disease is not uniform among South Asians, and there are important differences between Indians, Pakistanis, and Bangladeshis for many coronary risk factors. The belief that, except for insulin resistance, South Asians have lower levels of coronary risk factors than Europeans is incorrect, and may have arisen from combining ethnic subgroups and examining a narrow range of factors.

Sex difference in blood pressure among South Asian diaspora in Europe and North America and the role of BMI: a meta-analysis

“…Participants were sampled from general practitioner registers or health centres and community hospital registries. 12,[14][15][16][17][18] Two studies used samples from a population or community register. 20,21 One study used samples from areas as identified by the postcode directory.…”

“…17,18 Three studies reported on multiple South Asian subgroups (Indian, Pakistani, Bangladeshi) separately, 18,22,23 others reported only one subgroup or a combined South Asian population. [14][15][16][17]19,20,26 Most studies used Hawksley random zero sphygmomanometers to measure BP, 15,16,19 whereas two studies used mercury, 18,21 or automated devices such as the Omron (OMRON, Omron Matsusaka Co. Ltd, Kyoto, Japan), Dinamap 8100 (GE Healthcare, Critikon, FL, USA) and Roche (F Hoffmann-La Roche Ltd., Basel, Switzerland) sphygmomanometers. 12,17,20,23 Subjects were seated and quiet for at least 5 min before BP measurement.…”

“…12,17,20,23 Subjects were seated and quiet for at least 5 min before BP measurement. 12,14,15,[17][18][19][20][21] In three studies, 12,17,20 the average of the second and third BP reading was reported and in the other studies, the average of two BP readings (Table 1).…”

“…After contacting three authors to request additional data [11][12][13] and after full text review, the search resulted in 11 eligible articles (Figure 1). [14][15][16][17][18][19][20][21][22] The EMBASE and Google Scholar search did not yield additional articles. A cited reference search resulted in one newly identified article.…”

“…Six studies provided data on hypertension that was defined as X140/90 or receiving anti-hypertension 17,18,20,22,23,26 In all studies, the prevalence of hypertension was higher in men than in women.…”