Abstract
BackgroundMultiple vascular risk factors may confer very high risk, but the degree of commonality between risk factors is unclear, particularly among ethnic minorities. Furthermore, it is unknown what impact this commonality will have on the UK-based NHS Health Check Programme; a vascular disease prevention programme that screens individuals aged 40–74 years. We estimated the joint prevalence of diabetes, impaired glucose regulation (IGR), high cardiovascular disease (CVD) risk and chronic kidney disease (CKD) among White Europeans and South Asians who would be eligible for the Programme.MethodsCross-sectional data were analysed for 3707 participants (23.6% South Asian) in a screening study set in Leicestershire, UK. Diabetes and IGR were screen-detected. CKD may have been diagnosed previously. IGR was defined as impaired fasting glucose and/or impaired glucose tolerance, and high CVD risk as 10 year risk greater than 20%.ResultsAmong males, South Asians had higher prevalence than White Europeans of diabetes (9.0% vs. 3.9%, respectively, p<0.001), IGR (12.5% vs. 9.2%, p = 0.06), and high CVD risk (39.1% vs. 33.1%, p = 0.03), but lower prevalence of CKD (1.5% vs. 4.6%, p<0.01). Among females, South Asians had higher prevalence than White Europeans of diabetes (7.4% vs. 3.3%, p<0.001), but lower prevalence of CKD (3.7% vs. 13.0%, p <0.001) and CVD risk (2.4% vs. 4.6%, p = 0.03), and a non-significant difference in IGR prevalence. At least one risk factor was diagnosed in 34% of participants, and all of them in 0.4%, suggesting that 723,589–734,589 more individuals each year will require monitoring following implementation of the Health Check Programme.ConclusionsThe collective prevalence of risk factors for vascular disease in this population was high, but there was little overlap between the risk factors, and prevalence differed by ethnicity. This has implications for service delivery and resources, and should be considered when planning screening and intervention programmes.
Highlights
Whilst the cumulative atherogenic effect of vascular risk factor clustering is well recognised, the degree of commonality of individual components within large populations is less clear, among mixed ethnic populations, despite the wellestablished associations between ethnicity and vascular disease
The aim of this study was to estimate the individual and joint prevalence of screen-detected type 2 diabetes, impaired glucose regulation (IGR; defined by impaired fasting glucose and/or impaired glucose tolerance), high cardiovascular disease risk (CVD; defined as 10 year risk greater than 20%), and chronic kidney disease (CKD) as vascular risk factors in White Europeans and South Asians screened as part of a population based diabetes screening programme
A total of 6749 participants were screened in ADDITION-Leicester, 3042 of whom were not eligible for these analyses meaning that 3707 participants were included (874 South Asians and 2833 White Europeans)
Summary
Whilst the cumulative atherogenic effect of vascular risk factor clustering is well recognised, the degree of commonality of individual components within large populations is less clear, among mixed ethnic populations, despite the wellestablished associations between ethnicity and vascular disease This is important because it may identify different groups of people at increased risk, facilitate identification of groups at very high risk, and drive efficiency by enabling targeted screening. Multiple vascular risk factors may confer very high risk, but the degree of commonality between risk factors is unclear, among ethnic minorities It is unknown what impact this commonality will have on the UK-based NHS Health Check Programme; a vascular disease prevention programme that screens individuals aged 40–74 years. We estimated the joint prevalence of diabetes, impaired glucose regulation (IGR), high cardiovascular disease (CVD) risk and chronic kidney disease (CKD) among White Europeans and South Asians who would be eligible for the Programme
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