Abstract 3757: Correlates of Preclinical Cardiovascular Disease in Indigenous and Non-Indigenous Australians
Background: The frequency of premature death from CVD in indigenous Australians (I) exceeds that in Caucasians (C). This is often attributed to the frequency of risk factors, especially type II diabetes (DM) in I. In this study we sought which risk factors and clinical characteristics were determinants of clinical or subclinical cardiovascular disease in indigenous and non-indigenous Australians with and without DM.
Methods: We studied 227 patients (147 men; 50±13y): 54 I with diabetes (I-DM), 65 I without DM (I-nDM), 52 C with DM (C-DM), and 56 C without DM (C-nDM). Carotid intima-media thickness (IMT) and brachial artery reactivity (BAR) were measured according to standard methods and compared with clinical data and cardiovascular risk factors.
Results: There were no significant differences in gender, BMI, SBP, or DBP between any of the groups. Furthermore, there was no difference in plasma HbA1c between CDM and IDM. However there were significant differences in cardiovascular risk factors between C and I and between DM and non-DM (table⇓). In both DM and non-DM IMT was significantly greater in I than in C, and IMT in IDM was significantly greater than in INDM. In a regression model age (β= .48; p< .0001), ethnicity (β=−.34; p< .0001) and smoking (β= .13; p< .007) were independent predictors of IMT.
Conclusions: Ethnicity appears to be an independent predictor of preclinical cardiovascular disease, even after correction for the high prevalence of cardiovascular risk factors in both DM and non DM indigenous Australians. Standard approaches to control currently known risk factors are vital to reduce the burden of cardiovascular disease, but in themselves may be insufficient to fully address the high prevalence in this population.