The ethnicity of heart disease

25 February 2011 Medical check-up

Cardiovascular diseases are the main cause of death in the UK, causing almost 170 000 deaths across England and Wales each year. People from some ethnic backgrounds are more likely to suffer premature cardiovascular disease than others - but we still don’t know much about how ethnicity affects these diseases.

The British Heart Foundation’s Coronary Heart Disease Statistics programme is examining this issue, supported by the Centre for Longitudinal Study Information and User Support. The Centre is one of the services funded by the ESRC Census Programme.

"From looking at a range of different data sources about mortality, morbidity, treatment and the prevalence of risk factors for coronary heart disease, we found that South Asians within the UK have higher rates of heart disease and diabetes, whereas the Black population within the UK have higher rates of stroke," says lead researcher Dr Peter Scarborough from the University of Oxford’s BHF Health Promotion Research Group. "There is some evidence of ethnic inequalities in access to treatment, and behavioural risk factors for heart disease – such as smoking, alcohol consumption, poor diet and physical inactivity - can vary widely between ethnic groups."

Identifying particular ethnic factors that influence cardiovascular disease is a complicated challenge. Ethnic differences in genetic makeup, cultural and social practices, and risk factors such as obesity and diabetes are all important factors, while measurements such as body mass index are less useful for non-white populations with different body mass ratios. Large communities of minority ethnic groups also live in deprived neighbourhoods, which adds socioeconomic issues to the range of health influences.

The new research findings have been published in the British Heart Foundation publication Ethnic differences in cardiovascular disease.

Findings include:

  • Black Caribbean, Indian , Pakistani and Bangladeshi men have a considerably higher prevalence of diabetes than the general population
  • The prevalence of binge drinking is much lower in ethnic minority groups than in the general population
  • Obesity is much less common in the South Asian community and in Chinese men than in the general population, according to body mass index measurements
  • Stroke incidence rates in the Black ethnic group are higher than in the White ethnic group for both sexes
  • Around a quarter of adults in England are current smokers. The prevalence of smoking ranges from 20 per cent in Indian men to 40 per cent in Bangladeshi men, and from two per cent in Bangladeshi women to 26 per cent in Irish women

"More work is needed to truly understand these ethnic differences in coronary heart disease rates in the UK. This work would be aided by improved data collection techniques," comments Dr Scarborough. "At present, more than ten percent of all hospital episodes are not coded for ethnicity. And measures for tracking both childhood and adult obesity levels, such as Body Mass Index, are poorly devised for investigating ethnic differences in obesity - despite the large health burden associated with the condition."

The research forms part of an ongoing series of reports on the burden of coronary heart disease in the UK that is published by the British Heart Foundation. The reports focus on aspects of this burden, such as social or geographic inequalities in coronary heart disease rates, and are available to download from www.heartstats.org.