Evidence map›Paper›PMID 29217719›Full record

ArticleBMJ open2017

Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies.

Kjersti S Rabanal, Haakon E Meyer, Grethe S Tell, Jannicke Igland, Romana Pylypchuk, Suneela Mehta, Bernadette Kumar, Anne Karen Jenum, Randi M Selmer, Rod Jackson

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 2 pooled it
1.5field-weighted citation impact, top 15% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Review
  10. Article
  11. Article
  12. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors at 4 institutions in 2 countries.

Kjersti S RabanalDivision for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Haakon E MeyerDivision for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Grethe S TellDivision for Health Data and Digitalisation, Norwegian Institute of Public Health, Bergen, Norway.
Jannicke IglandDepartment of Global Public Health and Primary Care, University of Bergen, Norway.
Romana PylypchukSchool of Population Health, University of Auckland, Auckland, New Zealand.
Suneela MehtaSchool of Population Health, University of Auckland, Auckland, New Zealand.
Bernadette KumarNorwegian Center for Minority Health Research, Oslo, Norway.
Anne Karen JenumFaculty of Health and Society, Institute of Health and Society, University of Oslo, Oslo, Norway.
Randi M SelmerDivision for Mental and Physical Health, Norwegian Institute of Public Health, Oslo, Norway.
Rod JacksonSchool of Population Health, University of Auckland, Auckland, New Zealand.
Norwegian Institute of Public Health · NOUniversity of Auckland · NZUniversity of Bergen · NOUniversity of Oslo · NO

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe objective was to prospectively examine potential differences in the risk of first cardiovascular disease (CVD) events between South Asians and Europeans living in Norway and New Zealand, and to investigate whether traditional risk factors could explain any differences.

methodsWe included participants (30-74 years) without prior CVD in a Norwegian (n=16 606) and a New Zealand (n=129 449) cohort. Ethnicity and cardiovascular risk factor information was linked with hospital registry data and cause of death registries to identify subsequent CVD events. We used Cox proportional hazards regression to investigate the relationship between risk factors and subsequent CVD for South Asians and Europeans, and to calculate age-adjusted HRs for CVD in South Asians versus Europeans in the two cohorts separately. We sequentially added the major CVD risk factors (blood pressure, lipids, diabetes and smoking) to study their explanatory role in observed ethnic CVD risk differences.

resultsSouth Asians had higher total cholesterol (TC)/high-density lipoprotein (HDL) ratio and more diabetes at baseline than Europeans, but lower blood pressure and smoking levels. South Asians had increased age-adjusted risk of CVD compared with Europeans (87%-92% higher in the Norwegian cohort and 42%-75% higher in the New Zealand cohort) and remained with significantly increased risk after adjusting for all major CVD risk factors. Adjusted HRs for South Asians versus Europeans in the Norwegian cohort were 1.57 (95% CI 1.19 to 2.07) in men and 1.76 (95% CI 1.09 to 2.82) in women. Corresponding figures for the New Zealand cohort were 1.64 (95% CI 1.43 to 1.88) in men and 1.39 (95% CI 1.11 to 1.73) in women.

conclusionDifferences in TC/HDL ratio and diabetes appear to explain some of the excess risk of CVD in South Asians compared with Europeans. Preventing dyslipidaemia and diabetes in South Asians may therefore help reduce their excess risk of CVD.

Indexed as

AdultAgedAsiaBlood PressureCardiovascular DiseasesCholesterolDiabetes MellitusDyslipidemiasEuropeFemaleHumansMaleMetabolic DiseasesMiddle AgedNew ZealandNorwayCholesterolcardiovascular diseasecohortethnicityprospectiverisk factorsSouth Asians

Identifiers

PMID29217719
PMCPMC5728264
OpenAlexW2772624325

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.