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Journal of Epidemiology and Community Health logoLink to Journal of Epidemiology and Community Health
. 1996 Apr;50(2):137–139. doi: 10.1136/jech.50.2.137

Ethnic differences in mortality from cardiovascular disease in the UK: do they persist in people with diabetes?

N Chaturvedi 1, J H Fuller 1
PMCID: PMC1060240  PMID: 8762376

Abstract

STUDY OBJECTIVE: To determine whether ethnic differences in cardiovascular disease mortality persist in people with non-insulin-dependent diabetes mellitus. DESIGN: This was an ecological study in which routine mortality data from 1985-86, which coded all mentioned causes of death, provided the numerator. The UK population derived from 1981 census formed the denominator. SETTING: United Kingdom. PARTICIPANTS: Records of all deaths in people aged 45 years and above were extracted if diabetes was mentioned anywhere on the death certificate. The denominator was aged five years to approximate to the 1986 population. Mortality rates where a cardiovascular underlying cause was given were compared between South Asians, African-Caribbeans, and those born in England and Wales. The latter group formed the standard for directly standardised rate ratios. MAIN RESULTS: Mortality from heart disease was approximately three times higher in diabetic South Asian born men and women than in those with diabetes born in England and Wales. This ethnic difference was greatest in the younger age group. Conversely, stroke mortality rates in African-Caribbeans were 3.5-4 times higher than those in the England and Wales population. Despite this high mortality from stroke, ischaemic heart disease death rates were not high in African-Caribbean men. CONCLUSIONS: Ethnic differences in cardiovascular mortality persisted and were greater in those with diabetes. Thus the high risk of heart disease should be targeted for intervention in South Asians, and the high rates of stroke targeted in African-Caribbeans.

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Selected References

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  1. Alleyne S. I., Cruickshank J. K., Golding A. L., Morrison E. Y. Mortality from diabetes mellitus in Jamaica. Bull Pan Am Health Organ. 1989;23(3):306–314. [PubMed] [Google Scholar]
  2. Banerji M. A., Lebovitz H. E. Coronary heart disease risk factor profiles in black patients with non-insulin-dependent diabetes mellitus: paradoxic patterns. Am J Med. 1991 Jul;91(1):51–58. doi: 10.1016/0002-9343(91)90073-7. [DOI] [PubMed] [Google Scholar]
  3. Barrett-Connor E., Wingard D. L. Sex differential in ischemic heart disease mortality in diabetics: a prospective population-based study. Am J Epidemiol. 1983 Oct;118(4):489–496. doi: 10.1093/oxfordjournals.aje.a113654. [DOI] [PubMed] [Google Scholar]
  4. Chaturvedi N., McKeigue P. M., Marmot M. G. Relationship of glucose intolerance to coronary risk in Afro-Caribbeans compared with Europeans. Diabetologia. 1994 Aug;37(8):765–772. doi: 10.1007/BF00404333. [DOI] [PubMed] [Google Scholar]
  5. Chaturvedi N., McKeigue P. M., Marmot M. G. Resting and ambulatory blood pressure differences in Afro-Caribbeans and Europeans. Hypertension. 1993 Jul;22(1):90–96. doi: 10.1161/01.hyp.22.1.90. [DOI] [PubMed] [Google Scholar]
  6. Chaturvedi N., McKeigue P. M. Methods for epidemiological surveys of ethnic minority groups. J Epidemiol Community Health. 1994 Apr;48(2):107–111. doi: 10.1136/jech.48.2.107. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. DeStefano F., Newman J. Comparison of coronary heart disease mortality risk between black and white people with diabetes. Ethn Dis. 1993 Spring;3(2):145–151. [PubMed] [Google Scholar]
  8. Eschwege E., Richard J. L., Thibult N., Ducimetière P., Warnet J. M., Claude J. R., Rosselin G. E. Coronary heart disease mortality in relation with diabetes, blood glucose and plasma insulin levels. The Paris Prospective Study, ten years later. Horm Metab Res Suppl. 1985;15:41–46. [PubMed] [Google Scholar]
  9. Fuller J. H., Elford J., Goldblatt P., Adelstein A. M. Diabetes mortality: new light on an underestimated public health problem. Diabetologia. 1983 May;24(5):336–341. doi: 10.1007/BF00251820. [DOI] [PubMed] [Google Scholar]
  10. Goldschmid M. G., Barrett-Connor E., Edelstein S. L., Wingard D. L., Cohn B. A., Herman W. H. Dyslipidemia and ischemic heart disease mortality among men and women with diabetes. Circulation. 1994 Mar;89(3):991–997. doi: 10.1161/01.cir.89.3.991. [DOI] [PubMed] [Google Scholar]
  11. Kannel W. B., McGee D. L. Diabetes and cardiovascular disease. The Framingham study. JAMA. 1979 May 11;241(19):2035–2038. doi: 10.1001/jama.241.19.2035. [DOI] [PubMed] [Google Scholar]
  12. Kleinman J. C., Donahue R. P., Harris M. I., Finucane F. F., Madans J. H., Brock D. B. Mortality among diabetics in a national sample. Am J Epidemiol. 1988 Aug;128(2):389–401. doi: 10.1093/oxfordjournals.aje.a114979. [DOI] [PubMed] [Google Scholar]
  13. McKeigue P. M., Shah B., Marmot M. G. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991 Feb 16;337(8738):382–386. doi: 10.1016/0140-6736(91)91164-p. [DOI] [PubMed] [Google Scholar]
  14. Reaven G. M. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988 Dec;37(12):1595–1607. doi: 10.2337/diab.37.12.1595. [DOI] [PubMed] [Google Scholar]
  15. Stamler J., Vaccaro O., Neaton J. D., Wentworth D. Diabetes, other risk factors, and 12-yr cardiovascular mortality for men screened in the Multiple Risk Factor Intervention Trial. Diabetes Care. 1993 Feb;16(2):434–444. doi: 10.2337/diacare.16.2.434. [DOI] [PubMed] [Google Scholar]
  16. Stephenson J., Swerdlow A. J., Devis T., Fuller J. H. Recent trends in diabetes mortality in England and Wales. Diabet Med. 1992 Jun;9(5):417–421. doi: 10.1111/j.1464-5491.1992.tb01810.x. [DOI] [PubMed] [Google Scholar]
  17. Wingard D. L., Barrett-Connor E., Criqui M. H., Suarez L. Clustering of heart disease risk factors in diabetic compared to nondiabetic adults. Am J Epidemiol. 1983 Jan;117(1):19–26. doi: 10.1093/oxfordjournals.aje.a113510. [DOI] [PubMed] [Google Scholar]

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