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© 1988 Oxford University Press

research-article

Adult Male All-Cause, Cardiovascular and Cerebrovascular Mortality in Relation to Ethnic Group, Systolic Blood Pressure and Blood Glucose Concentration in Trinidad, West Indies

G J MILLER*,**, B R KIRKWOOD{ddagger}, G L A BECKLES**, S D ALEXIS{dagger}, D C CARSON{ddagger} and N T A BYAM{dagger}

*Department of Epidemiology and Social Medicine, Albert Einstein College of Medicine 1300 Morris Park Avenue, Bronx, New York 10461, USA
**The Caribbean Epidemiology Centre (PAHO/WHO) Port of Spain, Trinidad
{ddagger}Tropical Epidemiology Unit, London School of Hygiene and Tropical Medidne London, UK
{dagger}Government Nutrition Laboratories Port of Spain, Trinidad

In a prospective survey of 1342 Trinidadian men aged 35 to 69 years at recruitment, age-adjusted mean blood pressures were highest in those of African descent intermediate in Indians and men of Mixed origin, and lowest in Europeans. Age-adjusted fasting blood glucose concentrations were highest in Indians and lowest in men of European descent. Relative risks of all-cause, cardiovascular and cerebrovascular mortality increased progressively with increasing systolic pressure, whereas for fasting blood glucose concentration the associations were U-shaped. No ethnic differences were apparent in relative risks. For systolic pressure, mortality from all-causes and cardiovascular diseases respectively were about two and three times higher at 180 mmHg or more than at pressures below 130 mmHg. For blood glucose, all-cause and cardiovascular mortality were about four times higher at fasting concentrations >7.7 mmol/1 than in the lowest risk group (4.2–4.6 mmol/1). All-cause population attributable mortality rates for systolic pressures of 130 mmHg or more were 1.3 to 2.8 times higher in Indian men than in other groups. For blood glucose in excess of 4.6 mmol/1, population attributable mortality was between 2.9 and 6.9 times higher in Indians than in other groups. The findings emphasized the high mortality in men of Indian descent, partly due to an apparent underlying predisposition to cardiovascular disease, and partly to their high prevalence of diabetes mellltus.

Revised 1 April 1987


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