¹Northwick Park Hospital, Harrow, UK

Abstract

Population studies have shown a greater prevalence of cardiovascular (CV) morbidity and mortality in Asian Indian compared to white subjects, but longitudinal data in essential hypertension are limited. We followed-up 528 white and 106 Asian Indian subjects who underwent 24 hour intra-arterial ambulatory blood pressure (BP) monitoring a mean of 10 years earlier. Events consisted of 31 non-CV deaths, 26 coronary deaths, 7 cerebrovascular deaths, 46 myocardial infarctions, 20 strokes and 18 revascularisations. At baseline, Asian Indians were younger (469 vs 5211 yrs); p<0.001), had a higher prevalence of diabetes (17% vs 5%; p<0.001), lower cholesterol (5.61.1 vs 6.01.2mmol/l; p<0.001) a trend towards lower 24 hour systolic BP (15420 vs 15722mmHg) and a similar smoking history compared to whites, respectively. Event rates are listed below: (See Table)

Age (p<0.001), sex (p=0.002), smoking (p=0.05), previous CV disease (p<0.001), 24 hour systolic BP (p<0.006) and race (Asian Indians: whites hazard ratio 1.79; p=0.008) were independent predictors of events. The increased CV risk in Asian Indians was due to an excess of coronary events.