CMAJ • May 18, 2010; 182 (8). First published April 19, 2010; doi:10.1503/cmaj.091676
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Research

Comparison of cardiovascular risk profiles among ethnic groups using population health surveys between 1996 and 2007

Maria Chiu, MSc, Peter C. Austin, PhD, Douglas G. Manuel, MD MSc and Jack V. Tu, MD PhD

From the Institute for Clinical Evaluative Sciences (Chiu, Austin, Manuel, Tu), Toronto, Ont.; the Institute of Medical Science (Chiu, Tu) and the Dalla Lana School of Public Health (Austin, Tu), University of Toronto, Toronto, Ont.; the Division of Cardiology, Schulich Heart Centre, Department of Medicine (Tu), Sunnybrook Health Sciences Centre, Toronto, Ont.; Ottawa Hospital Research Institute (Manuel); and Statistics Canada (Manuel), Ottawa, Ont.

Correspondence to: Dr. Jack V. Tu, Institute for Clinical Evaluative Sciences, G106-2075 Bayview Ave., Toronto ON M4N 3M5; tu{at}ices.on.ca

Background: Although people of South Asian, Chinese and black ethnic backgrounds represent about 60% of the world’s population, most knowledge of cardiovascular risk is derived from studies conducted in white populations. We conducted a large, population-based comparison of cardiovascular risk among people of white, South Asian, Chinese and black ethnicity living in Ontario, Canada.

Methods: We examined the age- and sex-standardized prevalence of eight cardiovascular risk factors, heart disease and stroke among 154 653 white people, 3364 South Asian people, 3038 Chinese people and 2742 black people. For this study, we pooled respondent data from five cross-sectional health surveys conducted between 1996 and 2007: the National Population Health Survey of 1996 and the Canadian Community Health Survey, versions 1.1, 2.1, 3.1 and 4.1.

Results: The four ethnic groups varied considerably in the prevalence of the four major cardiovascular risk factors that we examined: for smoking, South Asian 8.6%, Chinese 8.7%, black 11.4% and white 24.8%; for obesity, Chinese 2.5%, South Asian 8.1%, black 14.1% and white 14.8%; for diabetes mellitus, white 4.2%, Chinese 4.3%, South Asian 8.1% and black 8.5%; and for hypertension, white 13.7%, Chinese 15.1%, South Asian 17.0% and black 19.8%. The prevalence of heart disease ranged from a low of 3.2% in the Chinese population to a high of 5.2% in the South Asian population, and the prevalence of stroke ranged from a low of 0.6% in the Chinese population to a high of 1.7% in the South Asian population. Although the black population had the least favourable cardiovascular risk factor profile overall, this group had a relatively low prevalence of heart disease (3.4%).

Interpretation: Ethnic groups living in Ontario had striking differences in cardiovascular risk profiles. Awareness of these differences may help in identifying priorities for the development of cardiovascular disease prevention programs for specific ethnic groups.


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Highlights
Can. Med. Assoc. J. 2010 182: 737. [Full Text] [PDF]



eLetters:

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Cardiovascular Disease Among South Asians-What Do We Really Know?
Pamela Verma
CMAJ, 25 Jun 2010 [Full text]
Response to Cardiovascular Disease Among South Asians—What Do We Really Know?
Jack Tu
CMAJ, 16 Jul 2010 [Full text]