ETHNIC-DIFFERENCES IN RISK MARKERS FOR HEART-DISEASE IN BRADFORD AND IMPLICATIONS FOR PREVENTIVE STRATEGIES

Objectives-To assess and compare the prevalence of established risk ma rkers for ischaemic heart disease in a sample of Asian and non-Asian m en and to relate these observations to preventive strategies. Setting- Two factories in the textile industry in Bradford, West Yorkshire, UK. Subjects-288 male manual workers aged 20 to 65 years. Design-Cross sec tional study within one occupational/social class stratum. Measurement s and main results-Age, body mass index, plasma lipids, fibrinogen and serum insulin values, blood pressure, smoking habits, alcohol consump tion, and exercise routines were recorded. Plasma total cholesterol co ncentrations were significantly lower in Asian than non-Asian men (5.3 mmol/l v 5.8 mmol/l respectively, p<0.0001), as were low density lipo protein cholesterol concentrations (3-4 mmol/l v 3.7 mmol/l, p=0.0150) , and high density lipoprotein (HDL) cholesterol (1-1 mmol/l v 1.3 mmo l/l, p<0.0001). Hypercholesterolaemia (concentration>6.5mM) was presen t in nearly one quarter of non-Asians but less than one eighth of Asia n men. Triglyceride values were not significantly higher in Asians. Sm oking rates were high in non-Asians (43.8%) and only slightly lower in Asians (39.1%). Asian smokers smoked fewer cigarettes per day on aver age (9-3 v 16-1, p=0.0001). Almost a quar-ter of non-Asian men (23.1%) and 26.6% of Asian men had raised blood pressure. Systolic pressures were higher in non-Asian men (138.3 mmHg v 133-0 mmHg, p=0.0070), but diastolic pressures showed no ethnic differences. Diabetes was more pr evalent in Asian men (10-9% v 4.4% p<0.05), who also showed higher ser um insulin concentrations after glucose loading (22-3 mU/l v 10.2 mU/l , p<0.0001). Plasma fibrinogen values were higher in non-Asian men (2. 9 g/l v 2.6 g/l, p<0.0001) and these were associated with smoking. Nea rly all non-Asians (92.5%) consumed alcohol at some time whereas 62-S% of Asians habitually abstained from alcohol consumption. Among the dr inkers, non-Asian men consumed on average, 23-9 units per week and Asi an men 18.4 units per week (p=0.083). The mean body mass index for Asi an men was 24.S k g/M2 which was not significantly different to the me an in non-Asian men (25.2 kg/m 2) . The frequency of exercise in leisu re time was low in both groups with 44-4% of non-Asian and 21.1% of As ian men taking moderate exercise weekly, and even fewer, regular stren uous exercise (16.3% and 8.6% respectively). Conclusions-The plasma ch olesterol and fibrinogen concentrations, prevalence of hypertension, s moking habits, alcohol intakes, and infrequency of exercise in leisure time in these non-Asian men in Bradford were consistent with an incre ased risk of heart disease. The pattern of risk markers was clearly di fferent in Asian men. Only their lower HDL cholesterol concentrations, marginally higher triglyceride values, higher prevalence of diabetes, and very low frequency of exercise in leisure time would be consisten t with a higher risk of heart disease compared with non-Asians. The im plications of these observations for heart disease preventive strategi es are discussed.