International Journal of Epidemiology 2001;30:983-988
© International Epidemiological Association 2001
Special Theme: Ethnicity |
Risk factors and incident coronary heart disease in Chinese, Malay and Asian Indian males: the Singapore Cardiovascular Cohort Study
a Department of Community, Occupational and Family Medicine, Faculty of Medicine, National University of Singapore, Singapore.
b Clinical Trials and Epidemiology Research Unit, National Medical Research Council, Singapore.
c Epidemiology and Disease Control Division, Ministry of Health, Singapore.
Dr Jeannette Lee, Department of Community, Occupational and Family Medicine, Faculty of Medicine, MD3, National University of Singapore, 16 Medical Drive, Singapore 117597. E-mail: cofleejm{at}nus.edu.sg
Abstract
Objective This prospective study in Singapore investigated the relationships of established coronary risk factors with incident coronary heart disease (CHD) for Chinese, Malay, and Asian Indian males.
Subjects A cohort (consisting of 2879 males without diagnosed CHD) derived from three previous cross-sectional surveys.
Methods Individual baseline data were linked to registry databases to obtain the first event of CHD. Hazard ratios (HR) or relative risks for risk factors were calculated using Cox's proportional hazards model with adjustment for age and ethnic group and adjustment for age, ethnic group and all other risk factors (overall adjusted).
Results There were 24 986 person-years of follow-up. The overall adjusted HR with 95% CI are presented here. Asian Indians were at greatest risk of CHD, compared to Chinese (3.0; 2.0–4.8) and Malays (3.4; 1.9–3.3). Individuals with hypertension (2.4; 1.6–2.7) or diabetes (1.7; 1.1–2.7) showed a higher risk of CHD. High low density lipoprotein cholesterol (LDL-C) (1.5; 1.0–2.1), high fasting triglyceride (1.5; 0.9–2.6) and low high density lipoprotein cholesterol (HDL-C) (1.3; 0.9–2.0) showed a lesser but still increased risk. Alcohol intake was protective with non-drinkers having an increased risk of CHD (1.8; 1.0–3.3). Obesity (body mass index 
30) showed an increased risk (1.8; 0.6–5.4). An increased risk of CHD was found in cigarette smokers of 20 pack years (1.5; 0.9–2.5) but not with lesser amounts.
Conclusions The increased susceptibility of Asian Indian males to CHD has been confirmed in a longitudinal study. All of the examined established risk factors for CHD were found to play important but varying roles in the ethnic groups in Singapore.
Keywords Coronary heart disease, risk factors, prospective, Chinese, Malays, Asian Indians
Accepted 3 April 2001
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