Ethnicity and risk of cardiovascular disease (CVD)

4.8 year follow-up of patients with type 2 diabetes living in Scotland

Muhammad Omar Malik, L. Govan, John R. Petrie, Nazim Ghouri, Graham Leese, Colin Fischbacher, Helen Colhoun, Sam Philip, Sarah Wild, Rory McCrimmon, Naveed Sattar, Scottish Diabetes Research Network Epidemiology Group

    Research output: Contribution to journalArticle

    12 Citations (Scopus)

    Abstract

    Aims/hypothesis: Potential differences in cardiovascular risk by ethnicity remain uncertain. We evaluated the association of ethnicity with cardiovascular disease (CVD) incidence in a large cohort of people with type 2 diabetes living in Scotland.

    Methods: Data from Scottish Care Information-Diabetes (SCI-Diabetes) were linked to Scottish Morbidity Records (SMR01) and National Records of Scotland data for mortality for dates between 2005 and 2011. Of 156,991 people with type 2 diabetes with coded ethnicity, 121,535 (77.4%) had no CVD at baseline (White: 114,461; Multiple Ethnic: 2,554; Indian: 797; Other Asian: 319; Pakistani: 2,250; Chinese: 387; African-Caribbean: 301 and Other: 466) and were followed up (mean ± SD: 4.8 ± 2.3 years) for the development of fatal and non-fatal CVD.

    Results: During follow-up, 16,265 (13.4%) patients developed CVD (ischaemic heart or cerebrovascular diseases). At baseline, Pakistanis were younger and had developed diabetes earlier, had higher HbA1c and longer duration of diabetes, but had lower BP, BMI, creatinine, proportion of smokers and proportion on antihypertensive therapy than whites. The age and sex adjusted HRs for CVD were HR 1.31 (CI 1.17, 1.47), p < 0.001 in Pakistanis and HR 0.66 (CI 0.47, 0.92), p = 0.014 in Chinese compared with whites. Adjusting additionally for an area measure of deprivation, duration of diabetes, conventional CVD and other risk factors, the HR for Pakistanis (HR 1.45 [CI 1.14, 1.85], p = 0.002) was significantly higher, and that for Chinese (HR = 0.58 [CI 0.24, 1.40], p = 0.228) lower, compared with whites.

    Conclusions/interpretation: Compared with whites with type 2 diabetes, those of Pakistani ethnicity in Scotland were at increased risk of CVD, whereas Chinese were at lower risk, with these differences unexplained by known risk factors.

    Original languageEnglish
    Pages (from-to)716-725
    Number of pages10
    JournalDiabetologia
    Volume58
    Issue number4
    DOIs
    Publication statusPublished - Apr 2015

    Fingerprint

    Scotland
    Type 2 Diabetes Mellitus
    Cardiovascular Diseases
    Cerebrovascular Disorders
    Antihypertensive Agents
    Myocardial Ischemia
    Creatinine
    Morbidity
    Mortality
    Incidence

    Keywords

    • Cardiovascular disease (CVD)
    • Cox-regression
    • Ethnicity
    • HbA
    • Longitudinal
    • Pakistani
    • Renal failure
    • Type 2 diabetes
    • White

    Cite this

    Malik, M. O., Govan, L., Petrie, J. R., Ghouri, N., Leese, G., Fischbacher, C., ... Scottish Diabetes Research Network Epidemiology Group (2015). Ethnicity and risk of cardiovascular disease (CVD): 4.8 year follow-up of patients with type 2 diabetes living in Scotland. Diabetologia, 58(4), 716-725. https://doi.org/10.1007/s00125-015-3492-0
    Malik, Muhammad Omar ; Govan, L. ; Petrie, John R. ; Ghouri, Nazim ; Leese, Graham ; Fischbacher, Colin ; Colhoun, Helen ; Philip, Sam ; Wild, Sarah ; McCrimmon, Rory ; Sattar, Naveed ; Scottish Diabetes Research Network Epidemiology Group. / Ethnicity and risk of cardiovascular disease (CVD) : 4.8 year follow-up of patients with type 2 diabetes living in Scotland. In: Diabetologia. 2015 ; Vol. 58, No. 4. pp. 716-725.
    @article{8cc090b9fcd04c889ea0eaf2e5cb87af,
    title = "Ethnicity and risk of cardiovascular disease (CVD): 4.8 year follow-up of patients with type 2 diabetes living in Scotland",
    abstract = "Aims/hypothesis: Potential differences in cardiovascular risk by ethnicity remain uncertain. We evaluated the association of ethnicity with cardiovascular disease (CVD) incidence in a large cohort of people with type 2 diabetes living in Scotland.Methods: Data from Scottish Care Information-Diabetes (SCI-Diabetes) were linked to Scottish Morbidity Records (SMR01) and National Records of Scotland data for mortality for dates between 2005 and 2011. Of 156,991 people with type 2 diabetes with coded ethnicity, 121,535 (77.4{\%}) had no CVD at baseline (White: 114,461; Multiple Ethnic: 2,554; Indian: 797; Other Asian: 319; Pakistani: 2,250; Chinese: 387; African-Caribbean: 301 and Other: 466) and were followed up (mean ± SD: 4.8 ± 2.3 years) for the development of fatal and non-fatal CVD.Results: During follow-up, 16,265 (13.4{\%}) patients developed CVD (ischaemic heart or cerebrovascular diseases). At baseline, Pakistanis were younger and had developed diabetes earlier, had higher HbA1c and longer duration of diabetes, but had lower BP, BMI, creatinine, proportion of smokers and proportion on antihypertensive therapy than whites. The age and sex adjusted HRs for CVD were HR 1.31 (CI 1.17, 1.47), p < 0.001 in Pakistanis and HR 0.66 (CI 0.47, 0.92), p = 0.014 in Chinese compared with whites. Adjusting additionally for an area measure of deprivation, duration of diabetes, conventional CVD and other risk factors, the HR for Pakistanis (HR 1.45 [CI 1.14, 1.85], p = 0.002) was significantly higher, and that for Chinese (HR = 0.58 [CI 0.24, 1.40], p = 0.228) lower, compared with whites.Conclusions/interpretation: Compared with whites with type 2 diabetes, those of Pakistani ethnicity in Scotland were at increased risk of CVD, whereas Chinese were at lower risk, with these differences unexplained by known risk factors.",
    keywords = "Cardiovascular disease (CVD), Cox-regression, Ethnicity, HbA, Longitudinal, Pakistani, Renal failure, Type 2 diabetes, White",
    author = "Malik, {Muhammad Omar} and L. Govan and Petrie, {John R.} and Nazim Ghouri and Graham Leese and Colin Fischbacher and Helen Colhoun and Sam Philip and Sarah Wild and Rory McCrimmon and Naveed Sattar and Lindsay, {Robert S.} and {Scottish Diabetes Research Network Epidemiology Group}",
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    Malik, MO, Govan, L, Petrie, JR, Ghouri, N, Leese, G, Fischbacher, C, Colhoun, H, Philip, S, Wild, S, McCrimmon, R, Sattar, N & Scottish Diabetes Research Network Epidemiology Group 2015, 'Ethnicity and risk of cardiovascular disease (CVD): 4.8 year follow-up of patients with type 2 diabetes living in Scotland', Diabetologia, vol. 58, no. 4, pp. 716-725. https://doi.org/10.1007/s00125-015-3492-0

    Ethnicity and risk of cardiovascular disease (CVD) : 4.8 year follow-up of patients with type 2 diabetes living in Scotland. / Malik, Muhammad Omar; Govan, L.; Petrie, John R.; Ghouri, Nazim; Leese, Graham; Fischbacher, Colin; Colhoun, Helen; Philip, Sam; Wild, Sarah; McCrimmon, Rory; Sattar, Naveed; Scottish Diabetes Research Network Epidemiology Group.

    In: Diabetologia, Vol. 58, No. 4, 04.2015, p. 716-725.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Ethnicity and risk of cardiovascular disease (CVD)

    T2 - 4.8 year follow-up of patients with type 2 diabetes living in Scotland

    AU - Malik, Muhammad Omar

    AU - Govan, L.

    AU - Petrie, John R.

    AU - Ghouri, Nazim

    AU - Leese, Graham

    AU - Fischbacher, Colin

    AU - Colhoun, Helen

    AU - Philip, Sam

    AU - Wild, Sarah

    AU - McCrimmon, Rory

    AU - Sattar, Naveed

    AU - Lindsay, Robert S.

    AU - Scottish Diabetes Research Network Epidemiology Group

    PY - 2015/4

    Y1 - 2015/4

    N2 - Aims/hypothesis: Potential differences in cardiovascular risk by ethnicity remain uncertain. We evaluated the association of ethnicity with cardiovascular disease (CVD) incidence in a large cohort of people with type 2 diabetes living in Scotland.Methods: Data from Scottish Care Information-Diabetes (SCI-Diabetes) were linked to Scottish Morbidity Records (SMR01) and National Records of Scotland data for mortality for dates between 2005 and 2011. Of 156,991 people with type 2 diabetes with coded ethnicity, 121,535 (77.4%) had no CVD at baseline (White: 114,461; Multiple Ethnic: 2,554; Indian: 797; Other Asian: 319; Pakistani: 2,250; Chinese: 387; African-Caribbean: 301 and Other: 466) and were followed up (mean ± SD: 4.8 ± 2.3 years) for the development of fatal and non-fatal CVD.Results: During follow-up, 16,265 (13.4%) patients developed CVD (ischaemic heart or cerebrovascular diseases). At baseline, Pakistanis were younger and had developed diabetes earlier, had higher HbA1c and longer duration of diabetes, but had lower BP, BMI, creatinine, proportion of smokers and proportion on antihypertensive therapy than whites. The age and sex adjusted HRs for CVD were HR 1.31 (CI 1.17, 1.47), p < 0.001 in Pakistanis and HR 0.66 (CI 0.47, 0.92), p = 0.014 in Chinese compared with whites. Adjusting additionally for an area measure of deprivation, duration of diabetes, conventional CVD and other risk factors, the HR for Pakistanis (HR 1.45 [CI 1.14, 1.85], p = 0.002) was significantly higher, and that for Chinese (HR = 0.58 [CI 0.24, 1.40], p = 0.228) lower, compared with whites.Conclusions/interpretation: Compared with whites with type 2 diabetes, those of Pakistani ethnicity in Scotland were at increased risk of CVD, whereas Chinese were at lower risk, with these differences unexplained by known risk factors.

    AB - Aims/hypothesis: Potential differences in cardiovascular risk by ethnicity remain uncertain. We evaluated the association of ethnicity with cardiovascular disease (CVD) incidence in a large cohort of people with type 2 diabetes living in Scotland.Methods: Data from Scottish Care Information-Diabetes (SCI-Diabetes) were linked to Scottish Morbidity Records (SMR01) and National Records of Scotland data for mortality for dates between 2005 and 2011. Of 156,991 people with type 2 diabetes with coded ethnicity, 121,535 (77.4%) had no CVD at baseline (White: 114,461; Multiple Ethnic: 2,554; Indian: 797; Other Asian: 319; Pakistani: 2,250; Chinese: 387; African-Caribbean: 301 and Other: 466) and were followed up (mean ± SD: 4.8 ± 2.3 years) for the development of fatal and non-fatal CVD.Results: During follow-up, 16,265 (13.4%) patients developed CVD (ischaemic heart or cerebrovascular diseases). At baseline, Pakistanis were younger and had developed diabetes earlier, had higher HbA1c and longer duration of diabetes, but had lower BP, BMI, creatinine, proportion of smokers and proportion on antihypertensive therapy than whites. The age and sex adjusted HRs for CVD were HR 1.31 (CI 1.17, 1.47), p < 0.001 in Pakistanis and HR 0.66 (CI 0.47, 0.92), p = 0.014 in Chinese compared with whites. Adjusting additionally for an area measure of deprivation, duration of diabetes, conventional CVD and other risk factors, the HR for Pakistanis (HR 1.45 [CI 1.14, 1.85], p = 0.002) was significantly higher, and that for Chinese (HR = 0.58 [CI 0.24, 1.40], p = 0.228) lower, compared with whites.Conclusions/interpretation: Compared with whites with type 2 diabetes, those of Pakistani ethnicity in Scotland were at increased risk of CVD, whereas Chinese were at lower risk, with these differences unexplained by known risk factors.

    KW - Cardiovascular disease (CVD)

    KW - Cox-regression

    KW - Ethnicity

    KW - HbA

    KW - Longitudinal

    KW - Pakistani

    KW - Renal failure

    KW - Type 2 diabetes

    KW - White

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    U2 - 10.1007/s00125-015-3492-0

    DO - 10.1007/s00125-015-3492-0

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