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The British Journal of Diabetes & Vascular Disease
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Hypertension, diabetes and cardiovascular risk in ethnic minorities in the UK

Francesco P Cappuccio

Department of Community Health Sciences, St Georges Hospital Medical School, Cranmer Terrace, London, SW17 0RE, UK, f.cappuccio{at}sghms.ac.uk

Antonio Barbato

Sally M Kerry

Mortality from coronary heart disease (CHD), stroke and end-stage renal failure (ESRF) is high in South Asian (Indo-Asian) migrants in the UK. This is associated with a high prevalence of diabetes and hypertension.

Mortality from stroke and ESRF is also high in migrants to the UK of black African origin. However, CHD mortality is low in this group. This pattern of mortality is also associated with a high prevalence of hypertension and diabetes.

Conventional risk factors, such as cigarette smoking and hypercholesterolaemia, are less prevalent in ethnic minority populations in the UK and unlikely to explain the differences seen between groups, although each risk factor is likely to contribute to the variation in vascular disease within each group.

Key Words: Hypertension • diabetes • metabolic syndrome • ethnicity • cardiovascular disease.

References

  • Ezzati M., Lopez AD, Rodgers A., Vander Hoorn S., Murray CJL. Selected major risk factors and global and regional burden of disease. Lancet 2002;360:1347-60.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Balarajan R. Ethnic differences in mortality from ischaemic heart disease and cerebrovascular disease in England and Wales. BMJ 1991;302:5604.
  • Wild S., McKeigue P. Cross sectional analysis of mortality by country of birth in England and Wales, 1970-92. BMJ 1997;314:705-10.[Abstract/Free Full Text]
  • Cappuccio FP Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin. J Hum Hypert 1997;11:571-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Fang J., Madhavan S., Alderman MH The association between birthplace and mortality from cardiovascular causes among black and white residents of New York City. N Engl J Med 1996;335:1545-51.[Abstract/Free Full Text]
  • Raleigh VS Diabetes and hypertension in Britain's ethnic minorities: implications for the future of renal services. BMJ 2001;314:209-13.
  • Cappuccio FP, Cook DG, Atkinson RW, Strazzullo P. Prevalence, detection and management of cardiovascular risk factors in different ethnic groups in South London. Heart 1997;78:555-63.[Abstract/Free Full Text]
  • Primatesta P., Bost L., Poulter NR Blood pressure levels and hypertension status among ethnic groups in England. J Hum Hypert 2000;14:143-8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Raleigh VS, Kiri V., Balarajan R. Variations in mortality from diabetes mellitus, hypertension and renal disease in England and Wales by country of birth. Health Trends 1996;28:122-7.
  • Cooper RS, Rotimi C., Ataman S. et al. The prevalence of hypertension in seven populations of West African origin. Am J Public Health 1997;87: 160-8.[Abstract/Free Full Text]
  • Poulter NR, Cappuccio FP, Chaturvedi N., Cruickshank JK High blood pressure and the African-Caribbean community in the UK. Birmingham: MediNews Ltd, 1997.
  • Kaufman JS, Rotimi CN, Brieger WR et al. The mortality risk associated with hypertension: preliminary results of a prospective study in rural Nigeria. J Hum Hypertens 1996;10:461-4.[Web of Science][Medline] [Order article via Infotrieve]
  • Plange-Rhule J., Phillips R., Acheampong JW, Saggar-Malik AK, Cappuccio FP, Eastwood JB Hypertension and renal failure in Kumasi, Ghana. J Hum Hypert 1999;13:37-40.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Whitty CJ, Brunner EJ, Shipley MJ, Hemingway H., Marmot MG Differences in biological risk factors for cardiovascular disease between three ethnic groups in the Whitehall II study. Atherosclerosis 1999;142: 279-86.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Gupta R., al Odat NA, Gupta VP Hypertension epidemiology in India: meta-analysis of 50 year prevalence rates and blood pressure trends. J Hum Hypertens 1996;10:465-72.[Web of Science][Medline] [Order article via Infotrieve]
  • Gupta R., Sharma AK Prevalence of hypertension and subtypes in an Indian rural population: clinical and electrocardiographic correlates. J Hum Hypertens 1994;8:823-9.[Web of Science][Medline] [Order article via Infotrieve]
  • Agyemang C., Bhopal RS Is the blood pressure of South Asian adults in the UK higher or lower than that in European white adults? A review of cross-sectional data. J Hum Hypert 2002;16:739-51.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Ramaiya KL, Swai AB, McLarty DG, Bhopal RS, Alberti Kgmm. Prevalences of diabetes and cardiovascular disease risk factors in Hindu Indian subcommunities in Tanzania. BMJ 1991;303:271-6.[Abstract/Free Full Text]
  • Primatesta P., Brookes M., Poulter NR Improved hypertension management and control. Results from the Health Survey for England 1998. Hypertension 2001;38:827-32.
  • Du X., Cruickshank JK, McNamee R., Saraee M. et al. Case-control study of stroke and the quality of hypertension control in Northwest England. BMJ 1997;314:272-6.[Abstract/Free Full Text]
  • Cappuccio FP, Siani A. Non-pharmacologic treatment of hypertension. In Crawford MH, Di MArco JP, eds. International Textbook of Cardiology. Section 3: Hypertensive Heart Disease, p 7.1-7.10. London-Edinburgh-New York-Philadelphia-St Louis-Sydney-Toronto: Mosby International, 2001.
  • He FJ, Markandu ND, Sagnella GA, MacGregor GA Importance of the renin system in determining blood pressure fall with salt restriction in black and white hypertensives. Hypertension 1998;32:820-4.[Abstract/Free Full Text]
  • Ramsay LE, Williams B., Johnston GD et al. Guidelines for management of hypertension: report of the third working party of the British Hypertension Society. J Hum Hypert 1999;13:569-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Cappuccio FP, Oakeshott P., Strazzullo P., Kerry SM Application of Framingham risk estimates to ethnic minorities in the UK and implications for primary prevention in general practice: a cross-sectional population based study. BMJ 2002;325:1271-4.[Abstract/Free Full Text]
  • Brown MJ, Cruickshank JK, Dominiczak AF et al. Better blood pressure control: how to combine drugs. J Hum Hypert 2003;17:81-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • McKeigue PM, Shah B., Marmot MG Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet 1991;337:382-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Harris TJ, Cook DG, Wicks PD, Cappuccio FP Impact of the new American Diabetes Association diagnostic criteria for diabetes and impaired fasting glucose on subjects from three different ethnic groups living in the UK. Nutr Metab Cardiovasc Dis 2000;10:305-09.[Web of Science][Medline] [Order article via Infotrieve]
  • Whincup PH, Gilg JA, Papacosta O. et al. Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children. BMJ 2002;324:635.[Abstract/Free Full Text]
  • Cappuccio FP, Cook DG, Atkinson RW, Wicks PD The Wandsworth Heart & Stroke Study. A population-based survey of cardiovascular risk factors in different ethnic groups. Methods and baseline findings. Nutr Metab Cardiovasc Dis 1998;8:371-85.[Web of Science]
  • Chaturvedi N., Jarrett J., Morrish N., Keen H., Fuller JH Differences in mortality and morbidity in African Caribbean and European people with non-insulin dependent diabetes mellitus: results of 20 year follow up of a London cohort of a multinational study. BMJ 1996;313:848-52.[Abstract/Free Full Text]
  • Cappuccio FP, Bell R., Perry IJ et al. Homocysteine levels in men and women of different ethnic and cultural background living in England. Atherosclerosis 2002;164:95-102.[Medline] [Order article via Infotrieve]
  • Cook DG, Cappuccio FP, Atkinson RW et al. Ethnic differences in fibrinogen levels: the role of environmental factors and the -fibrinogen gene. Am J Epidemiol 2001;153:799-806.[Abstract/Free Full Text]
  • Miller MA, Sagnella GA, Kerry SM, Strazzullo P., Cook DG, Cappuccio FP Ethnic differences in circulating adhesion molecules. The Wandsworth Heart & Stroke Study. Clin Sci 2003;104:591-8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • UKPDS group 39. Efficacy of atenolol and captopril in reducing risk of macrovascular and microvascular complications in type 2 diabetes. BMJ 1998;317:713-20.[Abstract/Free Full Text]
  • Hansson L., Zanchetti A., Carruthers SG et al. Effects of intensive blood pressure lowering and low-dose aspirin in patients with hypertension: principal results of the hypertension optimal treatment (HOT) randomised trial. Lancet 1998;351:1755-62.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Executive summary of the Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA 2001;285:2486-97.[Free Full Text]
  • Ness AR, Cappuccio FP, Atkinson RW, Khaw K.-T, Cook DG Plasma vitamin C levels in men and women from different ethnic backgrounds living in England. Int J Epidemiol 1999;28:450-5.[Abstract/Free Full Text]
  • Kulkarni KR, Markovitz JH, Nanda NC, Segrest JP Increased prevalence of smaller and denser LDL particles in Asian Indians. Arterioscler Thromb Vasc Biol 1999;19:2749-55.[Abstract/Free Full Text]
  • Kain K., Catto AJ, Grant PJ Impaired fibrinolyisis and increased fibrinogen levels in South Asian subjects. Atherosclerosis 2001;156:457-61.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Crook M., Kerai P., Andrews V., Lumb P., Swaminathan R. Serum sialic acid, a reputed cardiovascular risk factor, is elevated in South Asian men compared to European men. Ann Clin Biochem 1998;35:242-4.[Web of Science][Medline] [Order article via Infotrieve]
  • Baker EH, Dong YB, Sagnella GA et al. Association of hypertension with T594M mutation in β subunit of epithelial sodium channels in black people resident in London. Lancet 1998;351:1388-92.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Dong YB, Zhu HD, Sagnella GA, Carter ND, Cook DG, Cappuccio FP Association between the C825T polymorphism of the G protein β3-subunit gene and hypertension in blacks. Hypertension 1999;34:1193-6.[Abstract/Free Full Text]
  • Dong YB, Zhu HD, Baker EH et al. T594M and G442V polymorphisms of the sodium channel subunit and hypertension in a black population. J Hum Hypert 2001;15:425-30.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Sagnella GA, Rothwell MJ, Onipinla AK, Wicks PD, Cook DG, Cappuccio FP A population study of ethnic variations in the angiotensin-converting enzyme I/D polymorphism: relationships with gender, hypertension and impaired glucose metabolism. J Hypertens 1999;17:657-64.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Hall S., Talmud PJ, Cook DG et al. Frequency and allelic association of common variants in the lipoprotein lipase gene in different ethnic groups. The Wandsworth Heart & Stroke Study. Gen Epidemiol 2000;18: 203-16.[CrossRef]
  • Waterworth DM, Talmud PJ, Humphries SE et al. Variable effects of the ApoCIII -482C>T variant on insulin, glucose and triglyceride levels in different ethnic groups. The Wandsworth Heart & Stroke Study. Diabetologia 2001;44:245-8.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Hayes L., White M., Unwin N. et al. Patterns of physical activity and relationship with risk markers for cardiovascular disease and diabetes in Indian, Pakistani, Bangladeshi and European adults in a UK population. J Public Health Med 2002;24:170-8.[Abstract/Free Full Text]
  • Chambers JC, Obeid OA, Refsum H. et al. Plasma homocysteine concentrations and risk of coronary heart disease in UK, Indian, Asian and European men. Lancet 2000;355:523-7.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Mehrotra S., Ling KL, Bekele Y., Gerbino E., Earle KA Lipid hydroperoxide and markers of renal disease susceptibility in African-Caribbean and Caucasian patients with Type 2 diabetes mellitus. Diabet Med 2001; 18:109-15.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Fischbacher CM, Bhopal R., Rutter MK et al. Microalbuminuria is more frequent in South Asian than in European origin populations: a comparative study in Newcastle, UK. Diabet Med 2003;20:31-6.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]
  • Abuaisha B., Kumar S., Malik R., Boulton AJ Relationship of elevated urinary albumin excretion to components of the metabolic syndrome in non-insulin-dependent diabetes mellitus. Diabetes Res Clin Pract 1998; 39:93-9.[CrossRef][Web of Science][Medline] [Order article via Infotrieve]

The British Journal of Diabetes & Vascular Disease, Vol. 3, No. 4, 286-293 (2003)
DOI: 10.1177/14746514030030041101
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