The Wandsworth Heart and Stroke Study. A population-based survey of cardiovascular risk factors in different ethnic groups. Methods and baseline findings

Background and Aims: Around the world the risk of cardiovascular disease va ries by ethnic group. These differential risks are, in part, not acquired w ith migration, suggesting that generic make-lips may be important However; it is now clear that environmental and modifiable factors relating to diet and life-style play an important role. The aims of the present population-b ased survey in South London were (i) to estimate the prevalence of cardiova scular risk factors in both men and women of different ethnic background. ( ii) to provide data on current detection rates and management of hypertensi on and diabetes; (iii) to study the differences in cardiovascular risk fact ors "between" ethnic groups as well as the associations "within" each ethni c group; (iv) to study the distributions by ethnic group of new putative ri sk factors. Methods and Results: We carried out a population-based cross-sectional surv ey of 1,577 men and women all residents in a geographically-defined area of South London and belonging to the three ethnic groups mostly represented i n the area. There were 523 whites, 549 people of African origin and 505 of South Asian origin. They underwent a comprehensive screening including phys ical measurements, a questionnaire, blood and urine tests and an oral gluco se tolerance test. Amongst the results, hypertension was more common amongs t people of African origin whereas diabetes was by far the most important r isk factor amongst South Asians. The latter group displays a clear-cut meta bolic pattern suggestive of insulin resistance such as hyperinsulinaemia an d hyperglycemia, both fasting and post-lend high fasting triglycerides and low HDL-cholesterol levels and central obesity. Severe obesity amongst wome n of African origin is also of great concern. Conclusions: The focus of cardiovascular prevention in ethnic minorities sh ould concentrate on the improvement in the prevention, detection and manage ment of hypertension and diabetes, as well as of severe obesity in women of African origin. Preventive and therapeutic strategies developed and assess ed in white populations may not apply to ethnic minorities. Strategies shou ld be specifically developed, validated and assessed to consider both cultu ral acceptability and underlying susceptibility. These actions will require the involvement of both primary and secondary health care settings. (C) 19 98, Medikal Press.