Q J Med 2003; 96: 919-923
© Association of Physicians 2003; all rights reserved.
Ethnic trends in lipid tests in general practice
From the 1Department of Clinical Biochemistry, Manchester Royal Infirmary, 2Barlow Medical Centre, Manchester, 3Department of Epidemiology, University of Manchester, and 4Department of Clinical Biochemistry, Manchester Royal Infirmary, Manchester, UK
Background: South Asian migrants have a higher cardiovascular mortality than the indigenous population. Contributory factors may include a lower rate of cardiovascular risk assessment uptake and compliance.
Aim: To compare rates of lipid testing, follow-up and patterns of dyslipidaemia in South Asian and non-South-Asian populations in Manchester.
Design: Retrospective cross-sectional survey.
Methods: Lipid requests from 14 general practices were analysed, using name recognition software to assign ethnicity.
Results: Compared with non-South-Asians, the age-standardized rate of lipid testing in South Asians was similar in men at 12.1% (95%CI 11.6–12.6) vs. 11.2% (9.5–13.0), but higher in women at 18.6% (15.9–21.2) vs. 13.2% (12.6–13.7). Trends of cholesterol with repeat testing were similar in the two populations. However, South Asian women had lower mean levels of total cholesterol (5.50 vs. 5.68 mmol/l, p = 0.021), lower levels of HDL (1.20 vs. 1.46 mmol/l, p < 0.001), an excess of hypertriglyceridaemia (1.62 vs. 1.45 mmol/l, p = 0.035) and a greater proportion with cholesterol > 5.2 mmol/l combined with low HDL (43.1% vs. 20.2%, p = 0.002). South Asian men had lower levels of total cholesterol (5.17 vs. 5.37 mmol/l, p = 0.048) and lower levels of HDL (1.07 vs. 1.64 mmol/l, p < 0.001). There was no difference in the proportion of South Asians men and women with cholesterol < 5.2 mmol/l combined with low HDL.
Discussion: The rate of lipid testing and change in cholesterol levels with repeated testing did not differ between South Asian and non-South-Asian groups. The pattern of dyslipidaemia seen in this South Asian population, especially women, was different from that of the non-South-Asian population, with possible implications for cardiovascular risk assessment.
Address correspondence to Dr M.W. France, Department of Clinical Biochemistry, Manchester Royal Infirmary, CMMCUH NHS Trust, Oxford Road, Manchester M13 9WL. e-mail: mfrance{at}labmed.cmht.nwest.nhs.uk
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