Ethnicity and Sex: Intersectional Disadvantage in Cardiovascular Disease Risk in an Ageing Tri-Ethnic Cohort

Demelza Smeeth , UCL
Sophie Eastwood, UCL
Nishi Chaturvedi, UCL

Background: Ethnic minority populations are often at a higher risk of cardiovascular disease when compared to the host or majority populations of high-income countries. How these trends and their underlying risk factors interact with sex is currently under-researched. Methods: Using the tri-ethnic Southall and Brent Revisited (SABRE) UK-based cohort, we identified incident coronary heart disease (CHD) and stroke events over an average of 20+ years for White Europeans, and South Asian and African Caribbean first generation migrants. Cardiovascular risk factors were assessed at baseline (1988-91). Competing risks regression were used to identify differences in CHD or stroke incidence, considering unrelated fatalities. Results: In men, CHD incidence was higher in South Asians compared to Europeans, but lower in African Caribbeans. In women, this South Asian excess was even greater, while African Caribbeans no longer had the relative protection compared to Europeans. European women were at a lower risk of developing CHD than their male counterparts, however sex differences were diminished in South Asians and African Caribbeans. In comparison, the cumulative incidence of stroke was more consistent across groups. Population attributable fractions for common cardiovascular risk factors differed across sex and ethnicity groups reflecting differences in both underlying prevalence and association with CHD risk. Conclusions: CHD incidence is not experienced equally across ethnic minority and sex groups and showed vast differences indicative of individual and combined effects of both ethnicity and sex. These results highlight the importance of sex when examining health in minority groups.

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 Presented in Session 101. Intersectional Approaches to Migrant Populations