Ethnic differences in myocardial infarction in patients with hypertension: effects of diabetes mellitus

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Ethnic differences in myocardial infarction in patients with hypertension: effects of diabetes mellitus. / Patel, J; Lim, Hoong; Gunarathne, A; Tracey, I; Durrington, P; Hughes, Elizabeth; Lip, Gregory.

In: QJM, Vol. 101, No. 3, 25.01.2008, p. 231-236.

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Patel, J ; Lim, Hoong ; Gunarathne, A ; Tracey, I ; Durrington, P ; Hughes, Elizabeth ; Lip, Gregory. / Ethnic differences in myocardial infarction in patients with hypertension: effects of diabetes mellitus. In: QJM. 2008 ; Vol. 101, No. 3. pp. 231-236.

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@article{ff8e39bf92674575bb2aade60d956cca,
title = "Ethnic differences in myocardial infarction in patients with hypertension: effects of diabetes mellitus",
abstract = "BACKGROUND: It has been reported that hypertension carries a greater risk of myocardial infarction (MI) in South Asians living in the UK than in the indigenous British population. This has been attributed to some specifically Asian susceptibility factor. DESIGN: Using a longitudinal approach, we investigated the relationship between coronary heart disease (CHD) risk factors amongst hypertension patients attending Sandwell and City Hospitals, and the onset of cardiovascular events over a 5-year follow-up period. RESULTS: A total of 350 Caucasian (83.7% male) and 104 South Asian (66.3% male) patients with hypertension [age 63.7 (7.6) years and 57.1 (11.1) years respectively, P <0.001] were followed-up for a mean (SD) period of 64.7(12.1) months. There were 11 (6.4/1000 patient years) cases of MI in Caucasian patients vs. 11 (17.8/1000 patient years) in South Asians, with event-free survival times being significantly lower amongst South Asians (log-rank test P = 0.04). The prevalence of diabetes mellitus was 22.9% higher amongst South Asians (P <0.001), whilst mean serum cholesterol and fasting triglyceride levels were higher amongst Caucasians (P = 0.001). There were no ethnic differences in HDL cholesterol concentrations, the use of tobacco, statin therapy or anti-platelet therapies (all P = NS), or in composite endpoint (MI, angina, peripheral vascular disease, stroke, revascularization or death; P = 0.74). On Cox regression analysis of all independent cardiovascular risk variables, associated treatments and ethnicity, MI risk was associated with diabetes mellitus (odds ratio 3.77, 95%CI 1.55-9.15, P = 0.003) but not ethnicity per se (P = 0.26). CONCLUSION: Increased risk of MI in hypertensive South Asians in the United Kingdom appears to be the result of a higher prevalence of diabetes mellitus. Further work is required to understand the pathophysiological basis with which diabetes increases CHD risk in this ethnic group.",
author = "J Patel and Hoong Lim and A Gunarathne and I Tracey and P Durrington and Elizabeth Hughes and Gregory Lip",
year = "2008",
month = jan,
day = "25",
doi = "10.1093/qjmed/hcm151",
language = "English",
volume = "101",
pages = "231--236",
journal = "QJM: An International Journal of Medicine",
issn = "1460-2725",
publisher = "Oxford University Press",
number = "3",

}

RIS

TY - JOUR

T1 - Ethnic differences in myocardial infarction in patients with hypertension: effects of diabetes mellitus

AU - Patel, J

AU - Lim, Hoong

AU - Gunarathne, A

AU - Tracey, I

AU - Durrington, P

AU - Hughes, Elizabeth

AU - Lip, Gregory

PY - 2008/1/25

Y1 - 2008/1/25

N2 - BACKGROUND: It has been reported that hypertension carries a greater risk of myocardial infarction (MI) in South Asians living in the UK than in the indigenous British population. This has been attributed to some specifically Asian susceptibility factor. DESIGN: Using a longitudinal approach, we investigated the relationship between coronary heart disease (CHD) risk factors amongst hypertension patients attending Sandwell and City Hospitals, and the onset of cardiovascular events over a 5-year follow-up period. RESULTS: A total of 350 Caucasian (83.7% male) and 104 South Asian (66.3% male) patients with hypertension [age 63.7 (7.6) years and 57.1 (11.1) years respectively, P <0.001] were followed-up for a mean (SD) period of 64.7(12.1) months. There were 11 (6.4/1000 patient years) cases of MI in Caucasian patients vs. 11 (17.8/1000 patient years) in South Asians, with event-free survival times being significantly lower amongst South Asians (log-rank test P = 0.04). The prevalence of diabetes mellitus was 22.9% higher amongst South Asians (P <0.001), whilst mean serum cholesterol and fasting triglyceride levels were higher amongst Caucasians (P = 0.001). There were no ethnic differences in HDL cholesterol concentrations, the use of tobacco, statin therapy or anti-platelet therapies (all P = NS), or in composite endpoint (MI, angina, peripheral vascular disease, stroke, revascularization or death; P = 0.74). On Cox regression analysis of all independent cardiovascular risk variables, associated treatments and ethnicity, MI risk was associated with diabetes mellitus (odds ratio 3.77, 95%CI 1.55-9.15, P = 0.003) but not ethnicity per se (P = 0.26). CONCLUSION: Increased risk of MI in hypertensive South Asians in the United Kingdom appears to be the result of a higher prevalence of diabetes mellitus. Further work is required to understand the pathophysiological basis with which diabetes increases CHD risk in this ethnic group.

AB - BACKGROUND: It has been reported that hypertension carries a greater risk of myocardial infarction (MI) in South Asians living in the UK than in the indigenous British population. This has been attributed to some specifically Asian susceptibility factor. DESIGN: Using a longitudinal approach, we investigated the relationship between coronary heart disease (CHD) risk factors amongst hypertension patients attending Sandwell and City Hospitals, and the onset of cardiovascular events over a 5-year follow-up period. RESULTS: A total of 350 Caucasian (83.7% male) and 104 South Asian (66.3% male) patients with hypertension [age 63.7 (7.6) years and 57.1 (11.1) years respectively, P <0.001] were followed-up for a mean (SD) period of 64.7(12.1) months. There were 11 (6.4/1000 patient years) cases of MI in Caucasian patients vs. 11 (17.8/1000 patient years) in South Asians, with event-free survival times being significantly lower amongst South Asians (log-rank test P = 0.04). The prevalence of diabetes mellitus was 22.9% higher amongst South Asians (P <0.001), whilst mean serum cholesterol and fasting triglyceride levels were higher amongst Caucasians (P = 0.001). There were no ethnic differences in HDL cholesterol concentrations, the use of tobacco, statin therapy or anti-platelet therapies (all P = NS), or in composite endpoint (MI, angina, peripheral vascular disease, stroke, revascularization or death; P = 0.74). On Cox regression analysis of all independent cardiovascular risk variables, associated treatments and ethnicity, MI risk was associated with diabetes mellitus (odds ratio 3.77, 95%CI 1.55-9.15, P = 0.003) but not ethnicity per se (P = 0.26). CONCLUSION: Increased risk of MI in hypertensive South Asians in the United Kingdom appears to be the result of a higher prevalence of diabetes mellitus. Further work is required to understand the pathophysiological basis with which diabetes increases CHD risk in this ethnic group.

U2 - 10.1093/qjmed/hcm151

DO - 10.1093/qjmed/hcm151

M3 - Article

C2 - 18204065

VL - 101

SP - 231

EP - 236

JO - QJM: An International Journal of Medicine

JF - QJM: An International Journal of Medicine

SN - 1460-2725

IS - 3

ER -