Heterogeneity of coronary heart disease risk factors in Indian, Pakistani,Bangladeshi, and European origin populations: cross sectional study

Objective To compare coronary risk factors and disease prevalence among Ind ians, Pakistanis, and Bangladeshis, and in all South Asians (these three gr oups together) with Europeans. Design Cross sectional survey. Setting Newcastle upon Tyne. Participants 259 Indian, 305 Pakistani, 120 Bangladeshi, and 825 European m en and women aged 25-74 years. Main outcome measures Social and economic circumstances, lifestyle, self re ported symptoms and diseases, blood pressure, electrocardiogram, and anthro pometric, haematological, and biochemical measurements. Results There were differences in social and economic circumstances, lifest yles, anthropometric measures and disease both bet tween Indians, Pakistani s, and Bangladeshis and between all South Asians and Europeans. Bangladeshi s and Pakistanis were the poorest groups. For most risk factors, the Bangla deshis (particularly men) fared the worst: smoking was most common (57%) in that group, and Bangladeshis had the highest concentrations of triglycerid es (2.04 mmol/l) and fasting blood glucose (6.6 mmol/l) and the lowest conc entration of high density lipoprotein cholesterol (0.97 mmol/l). Blood pres sure, however, was lowest in Bangladeshis. Bangladeshis were the shortest(m en 164 cm tall v 170 cm for Indians and 174 cm for Europeans). A higher pro portion of Pakistani and Bangladeshi men had diabetes (22.4% and 26.6% resp ectively) than Indians (15.2%). Comparisons of all South Asians with Europe ans hid some important differences, but South Asians were still disadvantag ed in a wide range of risk factors. Findings in women were similar. Conclusion Risk of coronary heart disease is not uniform among South Asians , and there are important differences between Indians, Pakistanis, and Bang ladeshis for many coronary risk factors. The belief that, except for insuli n resistance, South Asians have lo lower levels of coronary risk factors th an Europeans is incorrect, and may have arisen fi om combining ethnic subgr oups and examining a narrow range of factors.