Marked differences in cardiovascular risk profiles in middle-aged and older Chinese residents: Evidence from a large Australian cohort

Jin, Kai; Neubeck, Lis; Gullick, Janice; Koo, Fung; Ding, Ding

Abstract

Objective
To examine and compare the prevalence of cardiovascular disease (CVD) and major cardiovascular risk factors among Chinese, mixed-Chinese and non-Chinese Australians and to examine the associations of risk factors with CVD outcomes across these groups.

Methods
Using data from 266,696 Australian participants from the 45 and Up Study (2006-2009), this study investigated cardiovascular risk among Chinese (n=3454), mixed-Chinese (n=1,062) and non-Chinese (n=262,180) participants. Poisson regression models with a robust error variance were used to estimate prevalence ratio (PR) and 95% confidence intervals (CI) for CVD (coronary heart disease (CHD) and stroke) and six risk factors (hypertension, diabetes, high cholesterol, smoking, overweight/obesity, physical inactivity) by ethnicity using non-Chinese participants as the reference group. Each outcome was adjusted for socio-demographic characteristics.

Results
Compared with non-Chinese Australians, Chinese had lower prevalence of CHD (prevalence ratio [PR] =0.67; 95% CI 0.59-0.75) and stroke (PR=0.67; 0.51-0.88). Of the risk factors, Chinese had higher prevalence of diabetes (PR=1.25; 1.12-1.39), smoking (PR=1.22; 1.04-1.43) and physical inactivity (PR=1.48; 1.41-1.55) but lower prevalence of hypertension (PR=0.90; 0.86-0.95), high cholesterol (PR=0.87; 0.79-0.95) and overweight/obesity (PR=0.46; 0.43-0.48). Mixed-Chinese had higher prevalence of CVD and worse CVD risk profiles compared with Chinese.

Conclusions
There are marked differences in the prevalence of CVD and risk factors among Chinese, mixed-Chinese and non-Chinese. The noticeable variations in CVD risk between Chinese and mixed-Chinese indicate that conventional classification of treating all Chinese as homogeneous could be misleading. More investigation into the health outcomes of mixed ancestry is warranted.

Citation

Jin, K., Neubeck, L., Gullick, J., Koo, F., & Ding, D. (2017). Marked differences in cardiovascular risk profiles in middle-aged and older Chinese residents: Evidence from a large Australian cohort. International Journal of Cardiology, 227, 347-354. https://doi.org/10.1016/j.ijcard.2016.11.062

• Journal Article Type: Article
• Acceptance Date: Nov 5, 2016
• Online Publication Date: Nov 8, 2016
• Publication Date: Jan 15, 2017
• Deposit Date: Nov 7, 2016
• Publicly Available Date: Nov 9, 2017
• Journal: International Journal of Cardiology
• Print ISSN: 0167-5273
• Publisher: Elsevier
• Peer Reviewed: Peer Reviewed
• Volume: 227
• Pages: 347-354
• DOI: https://doi.org/10.1016/j.ijcard.2016.11.062
• Keywords: Cardiovascular disease (CVD), CVD risk profiles, Chinese migrants,
• Public URL: http://researchrepository.napier.ac.uk/Output/412993
• Contract Date: Nov 10, 2016