Risk factors and incident coronary heart disease in Chinese, Malay and Asian Indian males: the Singapore Cardiovascular Cohort Study

ObjectiveThis prospective, study, in Singapore investigated the relationshi ps of established coronary, risk factors with incident coronary heart disea se (CHD) for Chinese, Malay, and Asian Indian males. Subjects A cohort (consisting of 2879 males without diagnosed CHD) derived from three previous cross-sectional surveys. Methods Individual baseline data were linked to registry databases to obtai n the first event of CHD. Hazard ratios (HR) or relative risks for risk fac tors were calculated using Cox's proportional hazards model with adjustment for age and ethnic group and adjustment for age, ethnic group and all othe r risk factors (overall adjusted). Results There were 24 986 person-years of follow-up. The overall adjusted H R with 95% Cl are presented here. Asian Indians were at greatest risk of CH D, compared to Chinese (3.0; 2.0-4.8) and Malays (3.4; 1.9-3.3). Individual s with hypertension (2.4; 1.6-2.7) or diabetes (1.7; 1.1-2.7) showed a high er risk of CHD. High low density lipoprotein cholesterol (LDL-C) (1.5; 1.0- 2.1), high fasting triglyceride (1.5; 0.9-2.6) and low high density lipopro tein cholesterol (HDL-C) (1.3; 0.9-2.0) showed a lesser but still increased risk. Alcohol intake was protective with nondrinkers having an increased r isk of CHD (1.8; 1.0-3.3). Obesity (body mass index greater than or equal t o 30) showed an increased risk (1.8; 0.6-5.4). An increased risk of CHD was found in cigarette smokers of greater than or equal to 20 pack years (1.5; 0.9-.2.5) but not with lesser amounts. Conclusions The increased susceptibility of Asian Indian males to CHD has b een confirmed in a longitudinal study. All of the examined established risk factors for CHD were found to play important but varying roles in the ethn ic groups in Singapore.