Ethnic differences in cardiovascular risk: examining differential exposure and susceptibility to risk factors

Ho, F., Gray, S. R. , Welsh, P. , Gill, J. M.R. , Sattar, N. , Pell, J. P. and Celis-Morales, C. (2022) Ethnic differences in cardiovascular risk: examining differential exposure and susceptibility to risk factors. BMC Medicine, 20(1), 149. (doi: 10.1186/s12916-022-02337-w) (PMID:35473626)

[img] Text
267268.pdf - Published Version
Available under License Creative Commons Attribution.

917kB

Abstract

Background: Ethnic differences in cardiovascular disease (CVD) risk have been known for decades, but a systematic exploration of how exposure and susceptibility to risk factors may contribute is lacking. This study aimed to investigate the potential impact of differential exposure and susceptibility between South Asian, Black, and White individuals. Methods: This is a population-based prospective cohort study of UK Biobank participants with a median follow-up of 11.3 years. The association between ethnic group and CVD risk was studied. Additional risk factors were then adjusted to examine mediations. Moderation analysis was conducted to identify whether risk factors had a stronger association in the ethnic minority groups. Population attributable fractions were also calculated to quantify the relative contributions of risk factors for each ethnic group. Results: When adjusted for only age and sex, there was a higher risk of CVD among South Asian (n=8815; HR [95% CI] 1.69 [1.59–1.79]) and Black (n=7526; HR [95% CI] 1.12 [1.03–1.22]) compared with White participants (n=434,809). The excess risk of Black participants was completely attenuated following adjustment for deprivation. Compared with White participants, the associations of BMI, triglycerides, and HbA1c with CVD were stronger in South Asians. Adiposity was attributable to the highest proportion of CVD regardless of ethnicity. Smoking had the second largest contribution to CVD among White and Black participants, and HbA1c among South Asian participants. Conclusions: Adiposity is an important risk factor for CVD regardless of ethnicity. Ethnic inequalities in CVD incidence may be best tackled by targeting interventions according to ethnic differences in risk profiles.

Item Type:Articles
Additional Information:This study was supported by the University of Glasgow reinvigorating research fund. UK Biobank was established by the Wellcome Trust Medical Research Council, Department of Health, Scottish government, and Northwest Regional Development Agency. It has also had funding from the Welsh assembly government and the British Heart Foundation.
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Celis, Dr Carlos and Pell, Professor Jill and Gray, Dr Stuart and Gill, Professor Jason and Ho, Dr Frederick and Sattar, Professor Naveed and Welsh, Dr Paul
Authors: Ho, F., Gray, S. R., Welsh, P., Gill, J. M.R., Sattar, N., Pell, J. P., and Celis-Morales, C.
College/School:College of Medical Veterinary and Life Sciences > Institute of Cardiovascular and Medical Sciences
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Public Health
Journal Name:BMC Medicine
Publisher:BioMed Central
ISSN:1741-7015
ISSN (Online):1741-7015
Copyright Holders:Copyright © 2022 The Authors
First Published:First published in BMC Medicine 20(1):149
Publisher Policy:Reproduced under a Creative Commons License

University Staff: Request a correction | Enlighten Editors: Update this record