Preventable Risk Factors for Coronary Heart Disease and Stroke Amongst Ethnic Groups in London

Abstract

Objectives. People of African Caribbean descent have higher mortality rates from stroke than other ethnic groups. However, little is known about the prevalence of stroke risk factors in UK ethnic minority groups. We investigated the prevalence of these risk factors amongst African Caribbeans, black Africans and whites. Design. A random sample of patients aged 45-74 registered with 16 general practices in south London was surveyed in 1995. Main outcome measures were: prevalence of hypertension, mean serum cholesterol, serum fibrinogen and glycosylated haemoglobin A1C. Logistic and linear regressions were used to determine ethnic differences in these measures. Results. Hypertension was more prevalent in black Caribbeans (79.4%) and black Africans (71.6%) than in whites (54.3%) ( p < 0.0001). There were ethnic group differences in mean random total cholesterol ( p < 0.0001), triglycerides ( p < 0.0001), fibrinogen ( p = 0.03), HDL ( p = 0.02) and HbA1C ( p < 0.0001). Whites had higher mean random total cholesterol, triglycerides and fibrinogen than black Caribbeans but lower HDL and HbA1C. Black Africans had similar rates to black Caribbeans for these risk factors apart from lower triglyceride levels. Conclusion. These differences in risk factors may partially explain the high stroke mortality rates in black Caribbeans and black Africans compared to whites. There was little difference in prevalence of these risk factors between black Caribbean and black African groups. Specific strategies targeted to each ethnic group need to be developed to reduce risk factors.