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South Asian men, black women and men show greatest decline in heart health over past decade in Ontario

August 10, 2015 Toronto

South Asian men and black women and men in Ontario today face levels of heart disease risk factors that are much higher than ten years ago. A new study from the Institute for Clinical Evaluative Sciences (ICES) shows dramatic increases in the rates of particular risk factors for these groups including diabetes, high blood pressure and obesity.

The study, published today in the journal BMJ Open, is the first in Canada to examine ethnic-specific cardiovascular risk factor trends over time.

“Our findings suggest that cardiovascular risk factor profiles are worsening at different rates for different ethnic groups, and with more than a decade’s worth of data, we are able to show for the first time that general trends don’t apply to all ethnic groups,” said Dr. Maria Chiu, lead author of the study and a scientist at ICES.

The study found that in the 12-year period from 2001 to 2012, rates of diabetes doubled among South Asian men and nearly doubled among black women. And although obesity rates increased across all ethnic groups and sexes, the largest increase was observed for Chinese men, whose rate more than doubled.

Chiu and her ICES colleagues identified 219,276 adult respondents (205,326 white, 5,620 South Asian, 4,368 Chinese, and 3,962 black) to the Canadian Community Health Survey from 2001 to 2012 and examined their self-reported measures of cardiovascular risk factors, including current smoking, diabetes, high blood pressure and obesity (having a body mass index of 30 or more).

“We cannot ignore the effect of socioeconomic factors, since we know that low income is closely related to poorer health,” says Chiu. “For example, we noted increasingly poor diets among ethnic minority groups, and the ethnic minority groups we studied reported household incomes that were on average $10,000 to $30,000 lower than those of the white group. We also see this income gap increasing for certain ethnic groups.”

The study findings included:

  • The prevalence of diabetes doubled among South Asian men (from 6.7 per cent to 15.2 per cent) and black women (from 6.3 per cent to 12.2 per cent).
  • In general, black women were most likely to be obese and less likely to consume fruits and vegetables regularly; they were also among those reporting the highest levels of psychosocial stress, the largest increase in high blood pressure rates, and one of the only groups that saw increases in smoking rates.
  • Obesity is on the rise for all groups, particularly for Chinese men whose rate of obesity more than doubled from 2.8 per cent to 5.9 per cent.
  • The proportion of South Asian men with inadequate consumption of fruits and vegetables increased significantly in 12 years, suggesting a progressively poorer diet.
  • White men had the highest rates of smoking, but smoking rates have been declining for most groups except black women and Chinese men.

“These risk factors—obesity, physical inactivity and poor diet—are important to monitor, not only for good heart health but also for preventing cancer, stroke, dementia and other major diseases. Awareness of ethnic-specific trends provides an opportunity for us to identify high-risk groups and target more effective prevention strategies,” explained Chiu.

“Temporal trends in cardiovascular disease risk factors among white, South Asian, Chinese and black groups in Ontario, Canada, 2001 to 2012: a population-based study,” was published today in BMJ Open.

Authors: Maria Chiu, Laura C. Maclagan, Jack V. Tu, and Baiju R. Shah

ICES is an independent, non-profit organization that uses population-based health information to produce knowledge on a broad range of health care issues. Our unbiased evidence provides measures of health system performance, a clearer understanding of the shifting health care needs of Ontarians, and a stimulus for discussion of practical solutions to optimize scarce resources. ICES knowledge is highly regarded in Canada and abroad, and is widely used by government, hospitals, planners, and practitioners to make decisions about care delivery and to develop policy.

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