(精选)Cardiovascular disease in Black Caribbeans and South Asians ...教学课件.pptVIP

Ethnic patterns in cardiovascular disease: findings from national surveys suggest change in risks across generations Seeromanie Harding University of Glasgow Heterogenous patterns of cardiovascular diseases among ethnic groups High rates of coronary heart disease (CHD) among South Asians but not Caribbeans High rates of hypertensive cardiovascular disease among Caribbeans The causes of ethnic differences in cardiovascular disease are unclear Very little known about when differences begin to emerge over the lifecourse 0 20 40 60 80 100 Stroke 0 50 100 150 200 250 300 350 Eng Wales India Pakistan Bangladesh Caribbean CHD Death rates/100 000 by country of birth, EW 1989-92 0 100 200 300 CHD Hypertension Stroke 400 0 100 200 300 400 CHD Hypertension Stroke Blacks born in South Blacks born in North East Whites Blacks born in Caribbean /100 000 /100 000 Death rates by birthplace, New York 1988-92, 45-64 years Men Women Fang J, Madhavan S, Alderman H N Engl J Med 1996; 335:1552-1558 Cappucio F 2004;33:387-388 Gillum 1996; 335(21):1597-1599 Gillum’s stages in the epidemiological evolution of cardiovascular disease patterns among people of sub-Saharan African origin 0 10 20 30 40 % 3 3.5 4 4.5 5 5.5 6 6.5 7 7.5 8 8.5 8.5 Fasting glucose mmol/l Cameroon-rural 0.5 Cameroon-urban 1.4 Jamaica 3.0 Manchester 6.4 International Comparisons: Glucose tolerance distributions among west African-origin people % diabetes (treated) Mbanya JC, Cruickshank JK, Forrester T et al. Diabetes Care 1999;22:434-40 BMI =25 kg/m2 for west African-origin populations 0 10 20 30 40 50 60 70 80 Rural Urban Jamaica Manchester Males Females Cameroon Mbanya JC, Cruickshank JK, Forrester T et al. Diabetes Care 1999;22:434-40 % These international population studies suggest that environmental factors play the major role in explaining ethnic patterns in cardiovascular disease In the UK, large government surveys (prospective cross-sectional)