RESUMO
Over 800 different missense mutations in the low density lipoprotein (LDL) receptor gene (LDLR) have been identified in patients with familial hypercholesterolaemia (FH). Only two of them, including the Alanine to Threonine change at position 370 (A370T), have been discovered in FH patients but do not cause FH. The frequency of the 370T allele has been reported worldwide to be between 0.022 and 0.070, with no clear association with high cholesterol levels or risk for coronary heart disease (CHD) and stroke. To explore this relationship in more detail we have determined this genotype in 2,659 healthy middle-aged (50-61 years) men participating in the prospective Second Northwick Park Heart Study, with 236 CHD and 67 stroke incident events. The genotype distribution was in Hardy-Weinberg equilibrium and in the no-event group the frequency of 370T was 0.046 (95% CI 0.040-0.052). Overall, there was no significant association of the 370T allele with any measured plasma lipid trait, and there was no difference in genotype distribution or allele frequency between the no-event and CHD (0.059; 95% CI 0.040-0.085) or stroke (0.037; 95% CI 0.012-0.085) groups ( p= 0.18 and 0.65, respectively). There was evidence for significant interaction ( p= 0.006) between body mass index (BMI) and genotype on CHD risk, with 370A homozygotes showing the expected higher CHD risk for those with higher BMI, whilst risk for 370T allele carriers was highest in men in the lowest tertile of BMI. The explanation for this association is unclear, and may simply be chance. Thus, these data confirm the absence of a significant impact of the A370T polymorphism on LDL receptor function, at least as measured by the effect on plasma lipid levels and CHD risk.
Assuntos
Doença das Coronárias/epidemiologia , Lipídeos/sangue , Polimorfismo de Nucleotídeo Único , Receptores de LDL/genética , Índice de Massa Corporal , Doença das Coronárias/diagnóstico , Doença das Coronárias/genética , Desoxirribonucleases de Sítio Específico do Tipo II , Genótipo , Homozigoto , Humanos , Hiperlipoproteinemia Tipo II/sangue , Hiperlipoproteinemia Tipo II/diagnóstico , Hiperlipoproteinemia Tipo II/genética , Lipídeos/análise , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Acidente Vascular Cerebral/diagnóstico , Acidente Vascular Cerebral/genética , Reino UnidoRESUMO
BACKGROUND: This study examined whether cardiorespiratory fitness is a risk factor for cardiovascular disease, myocardial infarction, and all-cause mortality in a low- to middle-income Trinidadian community of African, South Asian Indian, and European origin. Those of Indian descent have a distinctively high rate of myocardial infarction. METHODS: The St James Study is a prospective total community survey located in Port-of-Spain, Trinidad, West Indies. A random sample of 626 men aged 35-69 years, without angina of effort, previous myocardial infarction, partial or complete atrio-ventricular conduction defect, complete heart block, or exercise-induced asthma, was used for the assessment of cardiorespiratory fitness by cycle ergometry. Surveillance for morbidity and mortality was maintained for an average of 7.3 years. RESULTS: When the subjects were grouped into those with an age- and fat-free mass-adjusted peak oxygen uptake above and below the mean of 60.4 mmol/min (1.34 l/min), the hazard ratios (below/above) (95% confidence interval) for all-cause mortality, cardiovascular disease incidence, and incidence of myocardial infarction, after allowance for conventional cardiovascular risk factors, were 2.08 (1.23-3.52), 2.13 (1.22-3.69), and 2.36 (0.84-6.67), respectively. For those unable to achieve a level of work requiring an oxygen uptake of 67 mmol/min (1.5 l/min) during progressive exercise, the respective hazard ratios were 3.49 (1.57-7.76), 2.29 (1.21-4.33), and 5.45 (1.22-24.34). Indian ethnicity remained a predictor of myocardial infarction after allowance for cardiorespiratory performance. CONCLUSION: Low cardiorespiratory fitness is a risk factor for cardiovascular disease morbidity and mortality in the low- to middle-income developing community of Trinidad.
Assuntos
Adulto , Pessoa de Meia-Idade , Idoso , Humanos , Masculino , População Negra/estatística & dados numéricos , Antropometria , Pressão Sanguínea , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Angiopatias Diabéticas/etnologia , Angiopatias Diabéticas/fisiopatologia , Eletrocardiografia , Infarto do Miocárdio/etnologia , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/fisiopatologia , Fatores de Risco , Trinidad e TobagoRESUMO
BACKGROUND: This study examined whether cardiorespiratory fitness is a risk factor for cardiovascular disease, myocardial infarction, and all-cause mortality in a low- to middle-income Trinidadian community of African, South Asian Indian, and European origin. Those of Indian descent have a distinctively high rate of myocardial infarction. METHODS: The St James Study is a prospective total community survey located in Port-of-Spain, Trinidad, West Indies. A random sample of 626 men aged 35-69 years, without angina of effort, previous myocardial infarction, partial or complete atrio-ventricular conduction defect, complete heart block, or exercise-induced asthma, was used for the assessment of cardiorespiratory fitness by cycle ergometry. Surveillance for morbidity and mortality was maintained for an average of 7.3 years. RESULTS: When the subjects were grouped into those with an age- and fat-free mass-adjusted peak oxygen uptake above and below the mean of 60.4 mmol/min (1.34 l/min), the hazard ratios (below/above) (95% confidence interval) for all-cause mortality, cardiovascular disease incidence, and incidence of myocardial infarction, after allowance for conventional cardiovascular risk factors, were 2.08 (1.23-3.52), 2.13 (1.22-3.69), and 2.36 (0.84-6.67), respectively. For those unable to achieve a level of work requiring an oxygen uptake of 67 mmol/min (1.5 l/min) during progressive exercise, the respective hazard ratios were 3.49 (1.57-7.76), 2.29 (1.21-4.33), and 5.45 (1.22-24.34). Indian ethnicity remained a predictor of myocardial infarction after allowance for cardiorespiratory performance. CONCLUSION: Low cardiorespiratory fitness is a risk factor for cardiovascular disease morbidity and mortality in the low- to middle-income developing community of Trinidad.
Assuntos
Doenças Cardiovasculares/etnologia , Causas de Morte , Aptidão Física , Adulto , Idoso , Antropometria , População Negra/estatística & dados numéricos , Pressão Sanguínea , Doenças Cardiovasculares/etiologia , Doenças Cardiovasculares/fisiopatologia , Angiopatias Diabéticas/etnologia , Angiopatias Diabéticas/fisiopatologia , Eletrocardiografia , Teste de Esforço/métodos , Inquéritos Epidemiológicos , Humanos , Índia/etnologia , Masculino , Pessoa de Meia-Idade , Infarto do Miocárdio/etnologia , Infarto do Miocárdio/etiologia , Infarto do Miocárdio/fisiopatologia , Consumo de Oxigênio , Fatores de Risco , Trinidad e Tobago/epidemiologia , População Branca/estatística & dados numéricosRESUMO
The presence of antibody to human T-cell leukaemia virus (HTLV-I) has been assessed in 2,143 men and women who represent 83 percent of all adults aged 35 to 69 years resident in a defined urban community in Trinidad. Individuals of African descent had a higher sero-positivity rate (7.0 percent) than those originating from India (1.4 percent), Europe (0 percent) or of mixed descent (2.7 percent). Women were infected more frequently than men, and the prevalence of infection increased with age in both sexes. Sero-positivity rates were significantly increased in adults who lived in housing of poor quality (p less than 0.001) or close to water courses (p less than 0.025). These data and others raise the possibility that one route of HTLV-I transmission may be via insect vectors under particular domestic circumstances.(AU)
Assuntos
Humanos , Adulto , Idoso , Pessoa de Meia-Idade , Habitação , Infecções por Deltaretrovirus/epidemiologia , Fatores Etários , Anticorpos Antivirais/análise , Infecções por Deltaretrovirus/etnologia , Infecções por Deltaretrovirus/transmissão , Trinidad e TobagoRESUMO
OBJECTIVE: To compare the incidence rates of hypertension and non-insulin dependent diabetes mellitus in relation to ethnicity and other characteristics in a rapidly developing community. DESIGN: Prospective surveillance of a total community for five years. SUBJECTS: Cohort of 2491 men and women aged 35 to 69 years (79 percent response), of African, Indian and other (mainly Afro-European) descent. RESULTS: During surveillance, secular increases ocurred in fasting blood glucose concentrations in both sexes and in Body Mass Index (BMI) in men with apparent secular reductions in systolic blood pressure in both sexes. Incidence rates of hypertension did not differ significantly with ethnicity, ranging between 31 and 41 per 1000 person-years in men and between 27 and 32 person-years in women. In men, the incidence of diabetes (per 1000 persons-years) in Indians (24) was significantly higher than in Africans (13) and others (11). In women the diabetic incidence was similar to that for men in Indians (23) and Africans 914), but in others was twice that in men 921). In both sexes, weight gain was an important risk factor for hypertension, whereas risk for diabetes increased with BMI at baseline. The increased risk of diabetes in Indians among men was independent baseline BMI and blood glucose. CONCLUSION: Apart from the increased risk of diabetes in Indians, ethnicity had no significant influence on incidence rates hypertension and diabetes in Trinidad. Secular increases in blood glucose in both sexes and in BMI in men probably contributed to the concurrent increase in mortality from coronary heart disease in this community (AU).
Assuntos
Adulto , Idoso , Feminino , Humanos , Masculino , Diabetes Mellitus Tipo 2/epidemiologia , Hipertensão/epidemiologia , Envelhecimento/fisiologia , Glicemia/metabolismo , Pressão Arterial/fisiologia , Índice de Massa Corporal , Diabetes Mellitus Tipo 2/etiologia , Incidência , Estudos Retrospectivos , Fatores de Risco , Fatores Sexuais , Trinidad e Tobago/epidemiologiaRESUMO
A community survey of human T cell lymphotropic virus type I (HTLV-I) in Montserrat, West Indies, identified 22 instances in which 2 HTLV-I-seropositive adults lived within 60 m of each other (close pairs), compared with 7.8 expected (P<.001). Five of these close pairs were mother offspring or husband-wife. The remaining 17 pairs were of unrelated members in separate households. The percentages of male-female (41 percent), female-female (41 percent), and male-male (18 percent) types in these 17 pairs were similar to those among the 1377 similarly defined pairs in which neither or only 1 member was seropositive, affording no support for extramarital heterosexual activity as an explanation for the clustering observed. Thus, the demography of HTLV-I was not accounted for completely by sexual and mother-to-offspring tranmission. The predominace of clustering of unrelated HTLV-I-seropositive individuals in locations with high mosquito infestation raised the possibility of sporadic transmission of HTLV-I by hematophagous insects (AU)
Assuntos
21003 , Humanos , Feminino , Masculino , Idoso , Adulto , Idoso de 80 Anos ou mais , Infecções por HTLV-I/epidemiologia , Aedes , Anticorpos Antivirais/análise , Demografia , Dengue/epidemiologia , Exposição Ambiental , Infecções por HTLV-I/transmissão , Índias Ocidentais/epidemiologia , Insetos VetoresAssuntos
Adulto , Humanos , Masculino , HDL-Colesterol , LDL-Colesterol , Doença das Coronárias , Trinidad e TobagoRESUMO
Over 80 percent of the adult population of three villages in Montserrat donated blood samples for screening for HTLV-I and dengue antibodies. Twenty-five (7.2 percent) of the 349 samples tested were positive for HTLV-I antibodies and 17 of them live in 4 clusters of neighbouring households which was statistically significant. This clustering was not primarily due to viral or mother-to-child transmission but was the result of related and unrelated seropositive individuals living near to each other far more frequently than by chance alone. Two hundred and two (61 percent) of 331 samples tested were seropositive for dengue. Dengue seropositivity prevalence rates increased markedly with age and showed a strong difference in prevalence by altitude. This high prevalence of dengue seropositivity was surprising since no epidemics of dengue fever were reported in Montserrat. There is no evidence to support the hypothesis that the same insect vectors have a role in both dengue and HTLV-I transmission. However, the clustering observed, the inverse relation between HTLV-I sero prevalence and altitude and the failure of HTLV-I to establish itself in temperate climates, justify the need for further studies (AU)
Assuntos
Humanos , Adulto , Vírus Linfotrópico T Tipo 1 Humano , Dengue/epidemiologia , Índias Ocidentais , Anticorpos Anti-HTLV-I , Insetos Vetores , AltitudeRESUMO
Vital statistics indicate that cardiovascular disorders are now major causes of morbidity and mortality in many Caribbean communities. in Trinidad and Tobago, for example, the death rate from myocardial infarction is now similar to that in the UK and USA. In a 10-year prospective survey of 1386 men aged 35 to 69 years at entry, who belonged to a defined community in Port-of-Spain, Trinidad, serum high-density (HDL) and low-density (LDL) lipoprotein cholesterol concentrations were very similar to those found by the same methods in Bristol, England. The age-adjusted incidence of first coronary heart disease (CHD) events in men clinically free of the disease at recruitment (per 1000 person-years) was 16.4 in those of European origin, and 2.4 in men of mixed descent (the contemporaneous figure for Bristol was about 12/1000 person-years). Serum HDL and LDL cholesterol concentrations were strong and independent predictors of CHD in Trinidad, as they are in temperate climes. With efective control of tropical infectious diseases, and adoption of western patterns of consumerism, tropical developing communities will rapidly acquire the CHD risk factor status once more or less exclusive to developed populations in more temperate climes. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Doença das Coronárias/epidemiologia , Países em Desenvolvimento , Clima Tropical , Doença das Coronárias/sangue , Incidência , Índia/etnologia , HDL-Colesterol/sangue , LDL-Colesterol/sangue , Prevalência , Estudos Prospectivos , Tabagismo/sangue , Trinidad e Tobago/epidemiologiaRESUMO
In a prospective cardiovascular study of 1341 Trinidadian men aged 35-69 years undertaken between 1977 and 1986, the baseline prevalance rates of cardiac and arterial disease and diabetes mellitus were increased in the 118 (8.8 percent) who had been but were no longer regular drinkers. This finding suggested that awareness of these disorders was a discouragement to drinking alcohol. When this group and all with coronary heart disease (CHD) or diabetes at entry were excluded, a significant inverse trend was found between alcohol consumption in the week before recruitment and risk of CHD across the subsequent average follow-up of 7.5 years. Men who had taken 5-14 drinks had about half the CHD risk of those who had had no alcohol, even after allowance for age, ethnicity, smoking, blood pressure and serum cholesterol concentration. The overall morbidity and mortality experience in this community indicated a protective effect of alcohol against CHD, but adverse health consequences from multiple causes in drinkers who were alcohol dependent. (AU)
Assuntos
Humanos , Pessoa de Meia-Idade , Masculino , Consumo de Bebidas Alcoólicas , Doença das Coronárias/prevenção & controle , Nível de Saúde , Fatores Etários , Consumo de Bebidas Alcoólicas , Alcoolismo/epidemiologia , Doença das Coronárias/sangue , Doença das Coronárias/mortalidade , Seguimentos , Estudos Prospectivos , Inquéritos e Questionários , Fatores de Risco , Tabagismo/epidemiologia , Trinidad e Tobago/epidemiologiaRESUMO
Study objective- The aim of the study was to determine whether the inverse association between high density lipoprotein cholesterol concentration and risk of coronary heart disease described in people of European stock was also present in other racial groups. Design- The study was a prospective population survey. Cardiovascular risk factors were examined, including fasting serum lipid estimation (obtained at recruitment). Setting- This was a community based study within a defined survey area in Trinidad. Participants- All men aged between 35 and 69 years within the survey area were identified and followed between 1977 and 1986. Analysis was confined to those of African, Asian Indian, and mixed decent who were free of coronary heart disease at entry (n=960, 69 percent of age eligible men in the survey population). Measurements and main results- 64 men developed coronary heart disease during the study period. A strong inverse curvilinear relation was found between high density lipoprotein cholesterol and coronary heart disease incidence (p<0.005), independent of age or other relevant characteristics including low density lipoprotein cholesterol. Conclusions- A low serum concentration of high density lipoprotein cholesterol is a risk factor for coronary heart disease in non-whites as well as in whites. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Doença das Coronárias/etnologia , LDL-Colesterol/sangue , Doença das Coronárias/sangue , Doença das Coronárias/epidemiologia , Seguimentos , Estudos Prospectivos , Análise de Regressão , Fatores de Risco , Trinidad e Tobago/epidemiologia , Trinidad e Tobago/etnologiaRESUMO
In a prospective cardiovascular study of 1341 Trinidadian men aged 35-69 years undertaken between 1977 and 1986, the baseline prevalence rates of cardiac and arterial disease and diabetes mellitus were increased in the 118(8.8 percent) who had been but were no longer regular drinkers. This finding suggested that awareness of these disorders was a discouragement to drinking alcohol. When this group and all with coronary heart disease (CHD) or diabetes at entry were excluded, a significant inverse trend was found between alcohol consumption in the week before recruitment and risk of CHD across the subsequent average follow-up of 7.5 years. Men who had taken between 5-14 drinks had about half the CHD risk of those who had had no alcohol, even after allowance for age, ethnicity, smoking, blood pressure and cholesterol concentration. The overall morbidity and mortality experience in this community indicated a protective effect of alcohol against CHD, but averse health consequences from multiple causes in drinkers who were alcohol dependent. (AU)
Assuntos
Humanos , Adulto , Masculino , Consumo de Bebidas Alcoólicas , Trinidad e Tobago , Doença das Coronárias , Região do Caribe , Países em DesenvolvimentoRESUMO
A ten year community survey was undertaken to investigate the high coronary heart (CHI) incidence among people of Indian (South Asian) descent in Trinidad, West Indies. Of 2491 individuals aged 35-69, 2215 (89 percent) were examined and 2069 (83 percent) found to be clinically free of CHD at baseline. After exclusion of 71 of minority ethnic groups, 786 African, 598 Indian, 147 European and 467 adults of mixed descent were followed for CHD morbidity and mortality. In both sexes, adults of Indian origin had higher prevalence rates of diabetes mellitus, a low concentration of high density lipoprotein(HDL) cholesterol, and recent abstinence from alcohol than other ethnic groups. Indian men also had larger skinfold thicknesses than other men. In participants free of CHD at entry, the age-adjusted relative risk of a cardiac event believed due to CHD, was at least twice as high in Indian men and women as in other ethnic groups. In men, blood pressure, diabetes mellitus and low-density lipoprotein(LDL) cholesterol concentration were positively and independently related to risk of CHD, wheras alcohol consumption and HDL cholesterol concentration were inversely associated with risk after allowing for age and ethnic group. The ethnic contrast in CHD persisted when these characteristics were taken into account. In the smaller sample of women, only ethnic groups were predictive of CHD as defined. The failure of point estimates of risk to explain the high CHD incidence in Indians calls for focus on age of onset of risk and examination of other potential risk factors such as insulin concentration. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Doença das Coronárias/etnologia , Países em Desenvolvimento/estatística & dados numéricos , África/etnologia , Doença das Coronárias/sangue , Doença das Coronárias/epidemiologia , Europa (Continente)/etnologia , Seguimentos , Índia/etnologia , Modelos Lineares , HDL-Colesterol/sangue , Oriente Médio/etnologia , Prognóstico , Modelos de Riscos Proporcionais , Fatores de Risco , Trinidad e Tobago/epidemiologia , China/etnologiaRESUMO
A ten-year community survey was undertaken to investigate the high coronary heart disease(CHD) incidence among people of Indian(South Asian) descent in Trinidad, West Indies. Of 2491 individuals aged 35-69 years, 2215(89 percent) were examined and 2069(83 percent) found to be clinically free of CHD at baseline> After exclusion of 71 of minority ethnic groups, 786 African, 598 Indian, 147 European 467 adults of Mixed descent were followed for CHD morbidity and mortality. In both sexes, adults of Indian descent had higher prevalences rates of diabetes mellitus, a low concentration of high-density lipoprotein (HDL) cholesterol, and recent abstinence from alcohol than other ethnic groups. Indian men also had larger skinfold thickness than other men. In participants free of CHD at entry, the age adjusted relative risk of a cardiac event believed due to CHD was at least twice as high in Indian men and women as in other ethnic groups. In men , blood pressure, diabetes mellitus and low-density lipoprotein (LDL) cholesterol concentration were positively and independently related to risk of CHD, whereas alcohol consumption and HDL cholesterol concentration were inversely associated with risk after allowing for age and ethnic group. The ethnic contrasts in CHD persisted when these characteristics were taken into account. In the smaller sample of women, only ethnic group was predictive of CHD as defined. The failure of point estimates of risk to explain the high CHD incidence in Indians calls for focus on age of onset and examination of other potential risk factors such as insulin concentration (AU)
Assuntos
Humanos , Masculino , Feminino , Doença das Coronárias/etnologia , Trinidad e Tobago , Doença das Coronárias/etiologia , Região do Caribe , Países em DesenvolvimentoRESUMO
In a prospective survey of 1342 Trinidadian men aged 35 to 69 years at recruitment, age-adjusted mean blood pressures were highest in those of African descent, intermediate in Indians and men of Mixed origin, and lowest in Europeans. Age-adjusted fasting blood glucose concentrations were highest in Indians and lowest in men of European descent. Relative risks of all-cause, cardiovascular and cerebrovascular mortality increased progressively with increasing systolic pressure, whereas for fasting blood glucose concentration the associations were U-shaped. No ethnic differences were apparent in relative risk. For systolic pressure, mortality from all-causes and cardiovascular diseases respectively were about two and three times higher at 180mmHg or more than at pressures below 130 mmHg. For blood glucose, all-cause and cardiovascular mortality were about four times higher at fasting concentrations greater than 7.7 mmol/l than in the lowest risk group (4.2-4.6 mmol/l), All-cause population attributable mortality rates for systolic pressures of 130 mmHg or more were 1.3 to 2.8 times higher in Indian men than in other groups. For blood glucose in excess of 4.6 mmol/l, population attributable mortality was between 2.9 and 6.9 times higher in Indians than in other groups. The findings emphasized the high mortality in men of Indian descent, partly due to an apparent underlying predisposition to cardiovascular disease, and partly to their high prevalence of diabetes mellitus. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Glicemia/análise , Pressão Arterial , Doenças Cardiovasculares/mortalidade , Transtornos Cerebrovasculares/mortalidade , Doenças Cardiovasculares/etnologia , Doenças Cardiovasculares/fisiopatologia , Causas de Morte , Transtornos Cerebrovasculares/etnologia , Transtornos Cerebrovasculares/fisiopatologia , Índia/etnologia , Estudos Prospectivos , Fatores de Risco , Trinidad e TobagoRESUMO
The origins of the high standardized mortality ratio (SMR) for coronary heart disease (CHD) among Indians in Britain, and the low SMR for West Indian immigrants, have been explored by a community survey in London. Serum lipoproteins, plasma glucose, haemostatic factors and other putative risk characteristics were measured in 75 Indian, 64 European and 24 West Indian men aged 45-54 years. These represented 81 percent of men registered with a general practice and resident within a defined area. In 51 men, diet was assessed by 5-day weighed inventory. Plasma phospholipid fatty acids (PFA) were measured in 18 Indians and 19 Europeans with dietary records. The relatively high HDL and HDL2-cholesterol concentration, reduced fat intake, increased ratio of dietary polyunsaturated/saturated fat, relatively frequent use of alcohol, and lack of obesity in West Indians accorded with thier low SMR from CHD. By contrast, only the relatively low HDL and HDL2-cholesterol concentrations, infrequency of alcohol consumption, and lower proportion of PFA as n-3 fatty acids of marine origin afforded explanations for the high SMR of Indians. Hyperglycaemia appeared similarly prevalent in Indians and West Indians, but less common in Europeans. Of the haemostatic factors, West Indians had a relatively low VIIc (not statistically significant), while Indians had an increased platelet count and reduced platelet volume. Improved understanding of these ethnic differences in CHD mortality may depend upon elucidation of the contrasts in HDL-cholesterol concentration. (AU)
Assuntos
Humanos , Pessoa de Meia-Idade , Masculino , Doença das Coronárias/fisiopatologia , Dieta , Testes de Coagulação Sanguínea , Glicemia/análise , Pressão Arterial , Peso Corporal , Colesterol/sangue , Doença das Coronárias/sangue , Doença das Coronárias/etiologia , Europa (Continente)/etnologia , Ácidos Graxos Insaturados/sangue , Índia/etnologia , Lipoproteínas/sangue , Fatores de Risco , Índias Ocidentais/etnologiaRESUMO
In a prospective survey of 1342 Trinidadian men aged 35 to 69 years at recruitment, aged-adjusted mean blood pressures were highest in those of African descent, intermediate in Indians and men of Mixed origin, and lowest in Europeans. Age-adjusted fasting blood glucose concentrations were highest in Indians and lowest in men of European descent. Relative risks all-cause cardiovascular and cerebrovascular mortality increased progressively with increasing systolic pressure, whereas for fasting blood glucose concentration the association were U-shaped. No ethnic difference were about two and three times higher at 180 mmHg or more than at pressures below 130 mmhg. For blood glucose, all cause and cardiovascular mortality were about four times higher at fasting concentrations.7.7 mmol/i than in the lowest risk group (4.2-4.6 mmol.l). All cause population attributable mortality rates for systolic pressures of 130 mmhg or more were 1.3 to 2.8 times higher in Indian men than in other groups. For blood glucose in excess of 4.6 mmol/l, population attributable mortality was between 2.9 and 6.9 times higher in Indians than in other groups. The findings emphasized the high mortality in men of Indian descent, partly due to an apparent underlying predisposition to cardiovascular disease, and partly to their high prevalence of diabetes mellitus. (AU)
Assuntos
Humanos , Masculino , Transtornos Cerebrovasculares/mortalidade , Trinidad e Tobago/epidemiologia , Doenças Cardiovasculares/mortalidade , Região do Caribe , Países em DesenvolvimentoRESUMO
A prospective survey has been undertaken of a total community of 1343 men and 1149 women, aged 35-69 years at recruitment, living in Port-of-Spain, Trinidad. By comparison with adults of African descent, age-adjusted relative risks of death, from all causes and from cardiovascular diseases were significantly increased in those of Indian origin (1.5 and 2.6, respectively) and reduced in those of mixed descent (0.5 and 0.3, respectively). Adults of European descent had an all-cause and cardiovascular mortality relative risk of 0.8 and 2.1, respectively. These ethnic differences in risk were not explained by systolic blood pressure, fasting blood glucose concentration, serum high-density lipoprotein or low-density lipoprotein concentration, or smoking habits. Differences in risk of cardiovascular death between Indian and European men seemed to be accounted for by the high prevalence of diabetes in Indians (19 percent) but other ethnic contrasts in mortality were unrelated to diabetes mellitus (AU)
Assuntos
Adulto , Humanos , Doenças Cardiovasculares/mortalidade , Trinidad e Tobago , /mortalidadeRESUMO
A prospective survey has been undertaken of a total community of 1343 men and 1149 women, aged 35-69 years at recruitment, living in Port-of Spain, Trinidad. By comparison with adults of African descent, age-adjusted relative risks of death from all causes and from cardiovascular diseases were significantly increased in those of Indian origin (0.5 and 0.3, respectively). Adults of European descent had an all-cause and cardiovascular mortality relative risk of 0.8 and 2.1, respectively. These ethnic differences in risk were not explained by systolic blood pressure, fasting blood glucose concentration, serum high-density lipoprotein or low-density lipoprotein concentration, or smoking habits. Differences in risk of cardiovascular death between Indian and European men seemed to be accounted for by the high prevalence of diabetes in Indians (19 percent) but other ethnic contrasts in mortality were unrelated to diabetes mellitus. (AU)
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Masculino , Feminino , Doenças Cardiovasculares/mortalidade , Pressão Arterial , Serviços de Saúde Comunitária , Diabetes Mellitus Tipo 2/complicações , Teste de Tolerância a Glucose , Lipoproteínas HDL/sangue , Lipoproteínas LDL/sangue , Estudos Prospectivos , Risco , Tabagismo , Trinidad e Tobago , África/etnologia , Europa (Continente)/etnologia , Índia/etnologiaRESUMO
The St. James Cardiovascular Survey was established in 1977 to examine the relations of conventional risk factors to subsequent all-cause and cause-specific morbidiy and mortality among adults aged 35-69 years at recruitment. Up to April 30, 1985, 178 deaths were recorded among 1,343 male subjects and 80 deaths among 1,079 female subjects. After adjusting for age differences, risk of death from all causes was significantly associated with ethnic group in men (xý of 3 = 16.8, p<0.001) and women (xý of 3 = 13.2, p < .005). Risk was 55 percent and 45 percent higher for Indian men women relative to African men and women. Risk for Mixed subjects was lowest compared to African (40 percent lower in males, 60 percent lower in females). Cardiovasular diseases and malignant neoplasms were the major causes of death in men (70 percent) of total deaths) and women (62 percent of total deaths). Among men, cardiovascular disease was the principal cause of death in all ethnic groups but made a greater contribution to total mortality amon Indian (60 percent) and European (70 percent) men than in the African and Mixed (37 percent) men than in Indians (9 percent) and Europeans (7 percent). A similar pattern was observed in women. After adjusting for age, risk of death from heart disease was more than twice as high for Indian men as for African. Ethnic group was not associated with mortality from either cerebrovascular disease or malignant (AU)