Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin
Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin
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DOI：
10.1038/sj.jhh.1000516
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发表时间：
1997-09-01
影响因子：
2.7
通讯作者：
Cappuccio, FP
中科院分区：
文献类型：
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作者：
Cappuccio, FP
在英国的南亚移民中，冠心病(CHD)、中风和终末期肾功能衰竭的死亡率很高。这与糖尿病和高血压的高患病率有关，这些似乎是伴有胰岛素抵抗(高胰岛素血症)和中心性肥胖(基于高腰臀比而不是传统的体重指数衡量标准)的代谢综合征的表现，这与久坐不动的生活方式、高甘油三酯和低高密度脂蛋白-胆固醇有关。在移居英国的黑人移民(加勒比人和西非人)中，中风和终末期肾功能衰竭的死亡率很高，但在这一群体中，冠心病死亡率很低，这种死亡率模式与高血压和糖尿病的高患病率有关。根据体重指数的传统测量方法，这一群体往往肥胖(尤其是女性)，并患有高胰岛素血症、低甘油三酯和高高密度脂蛋白。在英国少数民族人口中，吸烟和高胆固醇血症等传统风险因素较少流行，不太可能解释组间的差异，尽管每个风险因素可能导致每个组内血管疾病的差异。移民研究的结果很难调和(从农村环境到城市环境)，指出主要环境影响心血管风险因素的变化与世界各地和随后几代人种族群体疾病的一致模式，提示一定程度的遗传易感性，重要的环境-基因交互作用可能是其中一些过程的基础。在市中心地区，高血压和糖尿病的检测和管理仍然不令人满意，并显示出种族来源的差异，欧洲国家主要针对白人人口采取的冠心病和中风控制策略可能不适合少数民族人口。
Mortality from coronary heart disease (CHD), stroke and end-stage renal failure are high in South Asian migrants in the UK. This is associated with high prevalence of diabetes and hypertension, These seem to be manifestations of a metabolic syndrome with insulin resistance (hyperinsulinaemia) and central obesity (based on high waist-to-hip ratio rather than on conventional measures of body mass index), This is associated with sedentary lifestyle, high serum triglycerides and low HDL-cholesterol.Mortality from stroke and end-stage renal failure are high in black migrants to the UK (both Caribbeans and West Africans), However, CHD mortality is low in this group, This pattern of mortality is associated with high prevalence of hypertension and diabetes, This group tends to be obese (particularly women) according to conventional measures of body mass index and to have hyperinsulinaemia, low serum triglycerides and high HDL-cholesterol.Conventional risk factors such as cigarette smoking and hypercholesterolaemia are less prevalent in ethnic minority populations in the United Kingdom and unlikely to explain the differences seen between groups, although each risk factor is likely to contribute to the variation in vascular disease within each group.There is difficulty in reconciling the results of migration studies leg, from rural to urban environments) pointing to major environmental influences on the changes in cardiovascular risk factors with the consistent pattern of disease of ethnic groups across the world and in subsequent generations, suggesting a certain degree of genetic susceptibility, Important environment-gene interplays might be underlying some of these processes.The detection and management of hyper-tension and diabetes are still unsatisfactory in inner city areas and show variations by ethnic origin, Strategies for the control of CHD and stroke adopted in European countries directed mostly to white populations may be inappropriate for ethnic minority populations.