Sudden death is less common than might be expected in underprivileged ethnic minorities at high cardiovascular risk

Hamaad, Ali; Ghattas, Angie; Hirani, Fatima; Lip, Gregory Y.H.; MacFadyen, Robert J.

doi:10.1016/j.ijcard.2005.03.020

Cited by 6 publications

(10 citation statements)

References 17 publications

(13 reference statements)

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“…In the UK, people of Afro-Caribbean or Asian-Indian origin are for the most part, recent immigrants and are likely to be genetically dissimilar to African Americans, who have a long-established presence in the US [15,16]. To assess the impact of racial/ethnic differences in risk factors (other than race/ethnicity) on predicted CHD risk, we used the UKPDS Risk Engine equation for whites treating the three NHANES 1999-2002 populations (white, black, Mexican American) as though they were the same race/ethnicity.…”

Section: Cardiovascular Disease Predictionmentioning

confidence: 99%

Predicted risk of coronary heart disease among persons with type 2 diabetes

Kirk

Bertoni²,

Case³

et al. 2007

Coronary Artery Disease

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Section: Cardiovascular Disease Predictionmentioning

confidence: 99%

Predicted risk of coronary heart disease among persons with type 2 diabetes

Kirk

Bertoni²,

Case³

et al. 2007

Coronary Artery Disease

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“…However the burden of cardiovascular disease (CVD) in the United Kingdom (UK) varies between ethnic groups and type of CVD diagnosis. [3] Compared to White UK residents, South Asian residents have been found to be at increased risk of angina,[4,5] myocardial infarction,[6] coronary heart disease[7,8] but lower risk of heart failure,[9] and out-of-hospital cardiac arrest[10,11]. In contrast, Black residents have been found to be at increased risk of stroke in most but not all studies[7,12,13] and similar or lower risk of heart failure[9,14] and other heart diseases compared to White UK residents.…”

Section: Introductionmentioning

confidence: 99%

“…In contrast, Black residents have been found to be at increased risk of stroke in most but not all studies[7,12,13] and similar or lower risk of heart failure[9,14] and other heart diseases compared to White UK residents. [15,7,11] Studies are lacking on ethnic differences in incidence of some cardiovascular disease diagnoses, specifically peripheral arterial disease, stroke subtypes, and abdominal aortic aneurysm.…”

Section: Introductionmentioning

confidence: 99%

Ethnicity and the first diagnosis of a wide range of cardiovascular diseases: Associations in a linked electronic health record cohort of 1 million patients

et al. 2017

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BackgroundWhile the association of ethnic group with individual cardiovascular diseases has been studied, little is known about ethnic differences in the initial lifetime presentation of clinical cardiovascular disease in contemporary populations.Methods and resultsWe studied 1,068,318 people, aged ≥30 years and free from diagnosed CVD at baseline (90.9% White, 3.6% South Asian and 2.9% Black), using English linked electronic health records covering primary care, hospital admissions, acute coronary syndrome registry and mortality registry (CALIBER platform). During 5.7 years median follow-up between 1997–2010, 95,224 people experienced an incident cardiovascular diagnosis. 69.9% (67.2%-72.4%) of initial presentation in South Asian <60 yrs were coronary heart disease presentations compared to 47.8% (47.3%-48.3%) in White and 40.1% (36.3%-43.9%) in Black patients. Compared to White patients, Black patients had significantly lower age-sex adjusted hazard ratios (HRs) for initial lifetime presentation of all the coronary disease diagnoses (stable angina HR 0.80 (95% CI 0.68–0.93); unstable angina– 0.75 (0.59–0.97); myocardial infarction 0.49 (0.40–0.62)) while South Asian patients had significantly higher HRs (stable angina– 1.67 (1.52–1.84); unstable angina 1.82 (1.56–2.13); myocardial infarction– 1.67 (1.49–1.87). We found no ethnic differences in initial presentation with heart failure (Black 0.97 (0.79–1.20); S Asian 1.04(0.87–1.26)). Compared to White patients, Black patients were more likely to present with ischaemic stroke (1.24 (0.97–1.58)) and intracerebral haemorrhage (1.44 (0.97–2.12)). Presentation with peripheral arterial disease was less likely for Black (0.63 (0.50–0.80)) and South Asian patients (0.70 (0.57–0.86)) compared with White patients.DiscussionWhile we found the anticipated substantial predominance of coronary heart disease presentations in South Asian and predominance of stroke presentations in Black patients, we found no ethnic differences in presentation with heart failure. We consider the public health and research implications of our findings.Trial RegistrationNCT02176174, www.clinicaltrials.gov

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“…Zheng et al showed that African Americans had a higher death rate then Caucasians or other minority groups whereas Hispanics had a lower death rate. Hamaad et al showed that Indo-Asians had lower death rates than Caucasians did, but a direct comparison to the study by Zheng et al is not possible since the studies were conducted in different countries and the ethnic distribution of minority groups may be different in those populations6,7. A better understanding of ethnic variations in both ST height and in the instance of sudden death will be required to determine whether there is a strong association between these differences.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, polymorphisms in genes coding for ion channels appear to differ across ethnic groups; some of these polymorphisms might lead to ST elevations associated with sudden death5. Finally, ethnic differences in the incidence of sudden death have been described and could be related to ethnic differences in repolarization properties 6,7. Thus, a better understanding of population and ethnic distribution of ST height could provide information as to whether ST elevation is a marker of arrhythmic risk.…”

mentioning

confidence: 99%