Risk of Incident Cardiovascular Disease and Cardiovascular Risk Factors in First and Second-Generation Indians: The Singapore Indian Eye Study

Abstract

Population-based data investigating generational differences in the risk of incident cardiovascular disease (CVD) and its risk determinants are rare. We examined the 6-year incidence of CVD and its risk factors in first- and second-generation ethnic Indians living in Singapore. 1749 participants (mean age [SD]: 55.5 [8.8] years; 47.5% male) from a population-based, longitudinal study of Indian adults were included for incident CVD outcome. Incident CVD was defined as self-reported myocardial infarction, angina pectoris or stroke which developed between baseline and follow-up. CVD-related risk factors included incident diabetes, hypertension, hyperlipidemia, obesity and chronic kidney disease (CKD). For incident CVD outcome, of the 1749 participants, 406 (23.2%) and 1343 (76.8%) were first and second-generation Indians, respectively. Of these, 73 (4.1%) reported incident CVD. In multivariable models, second-generation individuals had increased risk of developing CVD (RR = 2.04; 95% CI 1.04, 3.99; p = 0.038), hyperlipidemia (RR = 1.27; 95% CI 1.06, 1.53; p = 0.011), and CKD (RR = 1.92; 95% CI 1.22, 3.04; p = 0.005), compared to first-generation Indians. Second-generation Indians have increased risk of developing CVD and its associated risk factors such as hyperlipidemia and CKD compared to first-generation immigrants, independent of traditional CVD risk factors. More stratified and tailored CVD prevention strategies on second and subsequent generations of Indian immigrants in Singapore are warranted.

Type 2 diabetes risks and determinants in second-generation migrants and mixed ethnicity people of South Asian and African Caribbean descent in the UK

“…Studies of migrant offspring, and people of mixed ethnicity, where distribution and inter-relations of genetic and environmental explanatory factors differ, may offer fresh insights. Previous studies suggest second and subsequent generations of migrants are at persistently elevated risk [7][8][9][10]. Partial European ancestry has been associated with decreased and non-European ancestry with increased type 2 diabetes risk in admixed populations of Hispanic, African American, East Asian and European descent [11][12][13][14][15].…”

Factores sociodemográficos y clínicos asociados al control de la tensión arterial en pacientes hipertensos de un programa de crónicos en Boyacá, 2017

“…También es necesario mencionar que dentro de las características clínicas de la población estudiada se encontró que la mayoría presentó un perímetro abdominal inadecuado, un peso por encima de los parámetros de normalidad y un porcentaje representativo de personas con elevación de triglicéridos y con una tasa de filtración glomerular disminuida; estos hallazgos se asemejan a lo reportado por otros estudios en los que este tipo de pacientes presentaron circunferencia abdominal aumentada y sobrepeso, condiciones clínicas que al no ser adecuadamente manejadas se constituyen en los principales factores de riesgo que inciden en el control inadecuado de la tensión arterial, llevando al desarrollo de serias complicaciones de esta enfermedad como la Enfermedad Cerebro Vascular (ECV) o la insuficiencia cardiaca [9] [10] [11] [12]. Sobre la Tensión Arterial Media (T.A.M.)…”

“…En este contexto el autocuidado que la personas con HTA tenga es un aspecto fundamental en la evolución de su enfermedad, siendo en autocuidado según Orem "un fenómeno activo que requiere que las personas sean capaces de usar la razón para comprender su estado de salud y sus habilidades en la toma de decisiones para elegir el curso apropiado para la hipertensión arterial [3]." Las dificultades en lograr un adecuado control de la tensión arterial en las personas que padecen esta patología se pueden relacionar con múltiples y diferentes factores de acuerdo a los diferentes contextos socioculturales, esto a nivel global y regional, documentándose por ejemplo que aspectos como el género muestran influencia [4] [5] [6], que la enseñanza del autocuidado y el autocuidado que la persona ejerce son fundamentales [7], por ende el nivel del educativo también es un aspectos de relevancia [8], además de los parámetros que reflejan el comportamiento nutricional [9], entre otros.…”

Managing cardiovascular disease risk in South Asian kidney transplant recipients

“…In the United Kingdom, SA were almost four times as likely to report a history of MI compared to other groups[ 15 ]. CVD incidence may even be higher as succeeding generations of SA live outside South Asia[ 16 ].…”