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02-01-2012 | Cardiology | Article

Pakistani Scots more likely to have chest pain, angina than other Scots


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MedWire News: Scottish people of Pakistani origin are more likely to be admitted to hospital with chest pain and angina than those of other ethnicities, study findings show.

The findings call for practical clinical and public health action to focus prevention, as well as disease programs and research on the populations at greatest need, write Raj Bhopal (University of Edinburgh, UK) and co-authors.

They linked Census 2001 for Scotland data, involving 4.9 million people, to Scottish Community Health Index data, death records, and the Scottish hospital discharge/deaths database to investigate ethnic variations in chest pain and angina.

The researchers reported on ethnic groups according to the category labels provided in the Census 2001 data, but due to small numbers, they grouped Bangladeshi people with "Other South Asian," and Caribbean, African, Black-Scottish, and "Other Black" individuals into one group, called "African origin."

There was an increased chest pain/hospitalization rate among Indian, Other South Asian, and Pakistani people compared with White Scottish people, at rate ratios of 140.9-216.2 in men and 140.9-243.0 in women.

The rate ratios were comparatively low among other White British and Chinese people, at 76.1 and 67.6 in men, respectively, and 73.7 and 76.7 in women, respectively.

After adjusting for educational qualifications, the difference between White Scottish and Other White British was attenuated but was not abolished, and in Indian and Other South Asian men the risk ratios were higher.

Pakistani people had the highest risk for angina, at risk ratios of 189.3 in men and 159.7 in women, while Other White British, Other White, and Chinese people had the lowest risk, at 60.5-89.6 in men, and 67.4-85.2 in women, respectively.

Adjusting for education did not significantly alter these patterns, the authors note.

"This paper contributes to the European effort to tackle [cardiovascular disease] and ethnic inequalities," write the authors in the European Journal of Cardiovascular Prevention and Rehabilitation.

"It shows a method to study the phenomenon more widely in Europe through linkage, given the paucity of primary longitudinal research data."

It also "calls for studies to examine why some populations (eg Chinese in much of Europe) fare comparatively well so lessons can be learned," they add.

In a press statement, Bhopal commented: "Scots have among the highest rates of heart attacks in the world, but we have shown that, among residents of Scotland, those of Pakistani origin followed by those of Indian origin have beaten them."

"The most amazing thing is how the Chinese population has such low rates of heart disease - everyone in Scotland has something to learn from them."

MedWire ( is an independent clinical news service provided by Springer Healthcare Limited. © Springer Healthcare Ltd; 2011

By Piriya Mahendra

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