Premature cardiovascular events and mortality in south Asians with type 2 diabetes in the United Kingdom Asian Diabetes Study - effect of ethnicity on risk
Bellary, Srikanth, O'Hare, J. Paul, Raymond, Neil T., Mughal, S., Hanif, Wasim M., Jones, A., Kumar, Sudhesh and Barnett, A. H.. (2010) Premature cardiovascular events and mortality in south Asians with type 2 diabetes in the United Kingdom Asian Diabetes Study - effect of ethnicity on risk. Current Medical Research and Opinion, Vol.26 (No.8). pp. 1873-1879. ISSN 0300-7995Full text not available from this repository.
Official URL: http://dx.doi.org/10.1185/03007995.2010.490468
Background/Aim: People of south Asian origin have an excessive risk of morbidity and mortality from cardiovascular disease. We examined the effect of ethnicity on known risk factors and analysed the risk of cardiovascular events and mortality in UK south Asian and white Europeans patients with type 2 diabetes over a 2 year period.
Methods: A total of 1486 south Asian (SA) and 492 white European (WE) subjects with type 2 diabetes were recruited from 25 general practices in Coventry and Birmingham, UK. Baseline data included clinical history, anthropometry and measurements of traditional risk factors-blood pressure, total cholesterol, HbA1c. Multiple linear regression models were used to examine ethnicity differences in individual risk factors. Ten-year cardiovascular risk was estimated using the Framingham and UKPDS equations. All subjects were followed up for 2 years. Cardiovascular events (CVD) and mortality between the two groups were compared.
Trial registration number: ISRCTN 38297969.
Findings: Significant differences were noted in risk profiles between both groups. After adjustment for clustering and confounding a significant ethnicity effect remained only for higher HbA1c (0.50 [0.22 to 0.77]; P=0.0004) and lower HDL (-0.09 [-0.17 to -0.01]; P=0.0266). Baseline CVD history was predictive of CVD events during follow-up for SA (P<0.0001) but not WE (P=0.189). Mean age at death was 66.8 (11.8) for SA vs. 74.2 (12.1) for WE, a difference of 7.4 years (95% CI 1.0 to 13.7 years), P=0.023. The adjusted odds ratio of CVD event or death from CVD was greater but not significantly so in SA than in WE (OR 1.4 [0.9 to 2.2]).
Limitations: Fewer events in both groups and short period of follow-up are key limitations. Longer follow-up is required to see if the observed differences between the ethnic groups persist.
Conclusion: South Asian patients with type 2 diabetes in the UK have a higher cardiovascular risk and present with cardiovascular events at a significantly younger age than white Europeans. Enhanced and ethnicity specific targets and effective treatments are needed if these inequalities are to be reduced.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
R Medicine > RC Internal medicine
|Divisions:||Faculty of Medicine > Warwick Medical School > Health Sciences
Faculty of Medicine > Warwick Medical School > Translational & Systems Medicine > Metabolic and Vascular Health
Faculty of Medicine > Warwick Medical School
|Library of Congress Subject Headings (LCSH):||Cardiovascular system -- Diseases -- Risk factors -- Great Britain, Cardiovascular system -- Diseases -- Patients -- Great Britain, Non-insulin-dependent diabetes -- Risk factors -- Great Britain, South Asians -- Health and hygiene -- Great Britain, Europeans -- Health and hygiene -- Great Britain, Diabetics -- Great Britain|
|Journal or Publication Title:||Current Medical Research and Opinion|
|Official Date:||August 2010|
|Number of Pages:||7|
|Page Range:||pp. 1873-1879|
|Access rights to Published version:||Restricted or Subscription Access|
|Funder:||Pfizer Inc., sanofi aventis (Firm), Servier Laboratories Ltd., Merck Sharp & Dohme/Schering-Plough, Takeda UK, Roche, Merck Pharmaceuticals, Daiichi-Sankyo UK, Boehringer Ingelheim Pharmaceuticals (BIP), Eli Lilly and Company, Novo Nordisk, Bristol-Meyers Squibb (BMS), Solvay Pharmaceuticals, Assurance Medical Society UK (AMS UK)|
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