Abstract 14502: Variability in Traditional and Novel Cardiovascular Risk Factors by Ethnic Origin: Insights from the Primary Care Audit of Global Risk Management (PARADIGM) Study

Abstract

Background: Coronary heart disease is a primary public health concern both in North America and globally. Several studies have demonstrated that persons of South Asian origin (those originating from the Indian sub-continent) are at heightened risk for type 2 diabetes and premature coronary heart disease (CHD) compared to white Caucasians (WC), whereas Chinese populations are at lower risk.

Methods: The PARADIGM study enrolled 3015 otherwise healthy men (>40y) and women (>50y), free of vascular disease or diabetes, in an observational registry aimed at risk stratification using conventional and novel techniques. The present analysis reports on the prevalence of various traditional and non-traditional CHD risk factors in South Asian (SA) subjects (n=250, 8.3%) WC (n=2099, 69.6%) and Chinese subjects (n=266, 8.8%) within this cohort.

Results: (See table below) SA subjects, compared to WC and Chinese, had a higher body mass index (BMI), and were more likely to have metabolic syndrome (MS). Additionally, family history of premature vascular disease and hypertension were more common in SA. Impaired fasting glucose (IFG), hsCRP and low-density lipoprotein cholesterol (LDL-C) were significantly higher in SA when compared to Chinese but did not differ from WC. High-density lipoprotein cholesterol (HDL-C) was lower in SA; however, total cholesterol levels did not differ significantly between SA and other groups in multivariate analysis. SA were less likely to be categorized as moderate to high risk (42.6%) compared to WC (63.1%) by total cardiovascular Framingham Risk Score (FRS).

Conclusion: Considerable variability in the prevalence of traditional and novel CHD risk factors exists across SA, WC and Chinese subjects. Chinese had the lowest FRS, and WC had the highest FRS. SA had an intermediate FRS despite having a higher prevalence of many CHD risk factors. While this may partly be explained by their younger age, it is likely that FRS underestimates true risk in SA subjects.