Patel, Mubarak, Abatcha, Salim and Uthman, Olalekan (2022) Ethnic differences between South Asians and White Caucasians in cardiovascular disease-related mortality in developed countries : a systematic literature review. Systematic Reviews, 11 (1). 207. doi:10.1186/s13643-022-02079-z ISSN 2046-4053.

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Abstract

Background
Cardiovascular disease is the leading cause of death worldwide, with significantly worse mortality-related outcomes in ethnic minorities in developed countries. A systematic literature review and meta-analysis of observational studies was conducted to investigate cardiovascular disease-related mortality inequalities between South Asian and White Caucasian ethnic groups.

Methods
Published studies on mortality between South Asians and Whites in developed countries were retrieved from MEDLINE, PubMed, Embase, Web of Science, and grey literature sources (inception—April 2021) and critically appraised using the Quality in Prognosis Studies tool. Bayesian random-effects meta-analyses were performed for both primary and secondary outcomes. Heterogeneity was determined using the I2 statistic.

Results
Of the 9879 studies screened originally, 41 were deemed eligible. A further 3 studies were included via the later search. Of these, 15 reported cardiovascular disease-related mortality, 23 reported all-cause mortality, and 6 reported both.

The meta-analysis results showed that South Asians had a significantly increased risk of cardiovascular disease mortality compared to Whites (risk ratio = 1.32; 95% credible interval = 1.14 to 1.54) and a decreased risk of all-cause mortality (risk ratio = 0.95; 95% credible interval = 0.83 to 1.12).

Discussion
South Asians had statistically significantly higher odds of cardiovascular disease-related mortality compared to Whites, but not for all-cause mortality. Risk of bias was a serious concern mainly due to a lack of confounders being reported.

Systematic review registration
PROSPERO: CRD42021240865

Item Type:	Journal Article
Subjects:	R Medicine > RA Public aspects of medicine R Medicine > RC Internal medicine
Divisions:	Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School > Health Sciences > Population, Evidence & Technologies (PET) > Warwick Evidence Faculty of Science, Engineering and Medicine > Medicine > Warwick Medical School
Library of Congress Subject Headings (LCSH):	Cardiovascular system -- Diseases, Cardiovascular system -- Diseases -- Mortality -- Developed countries, Discrimination in medical care -- Developed countries, Discrimination in medical care -- Developed countries, Minorities -- Health and hygiene -- Developed countries, Ethnic groups -- Diseases -- Developed countries
Journal or Publication Title:	Systematic Reviews
Publisher:	BioMed Central Ltd.
ISSN:	2046-4053
Official Date:	29 September 2022
Dates:	Date Event 29 September 2022 Published 19 September 2022 Accepted 17 May 2022 Submitted
Volume:	11
Number:	1
Article Number:	207
DOI:	10.1186/s13643-022-02079-z
Status:	Peer Reviewed
Publication Status:	Published
Access rights to Published version:	Open Access (Creative Commons)
Date of first compliant deposit:	18 October 2022
Date of first compliant Open Access:	20 October 2022
RIOXX Funder/Project Grant:	Project/Grant ID RIOXX Funder Name Funder ID UNSPECIFIED University of Warwick Research Development Fund UNSPECIFIED

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