Edinburgh Napier University

  Objective
To examine and compare the prevalence of cardiovascular disease (CVD) and major cardiovascular risk factors among Chinese, mixed-Chinese and non-Chinese Australians and to examine the associations of risk factors with CVD outcomes across these groups.

Methods
Using data from 266,696 Australian participants from the 45 and Up Study (2006-2009), this study investigated cardiovascular risk among Chinese (n=3454), mixed-Chinese (n=1,062) and non-Chinese (n=262,180) participants. Poisson regression models with a robust error variance were used to estimate prevalence ratio (PR) and 95% confidence intervals (CI) for CVD (coronary heart disease (CHD) and stroke) and six risk factors (hypertension, diabetes, high cholesterol, smoking, overweight/obesity, physical inactivity) by ethnicity using non-Chinese participants as the reference group. Each outcome was adjusted for socio-demographic characteristics.

Results
Compared with non-Chinese Australians, Chinese had lower prevalence of CHD (prevalence ratio [PR] =0.67; 95% CI 0.59-0.75) and stroke (PR=0.67; 0.51-0.88). Of the risk factors, Chinese had higher prevalence of diabetes (PR=1.25; 1.12-1.39), smoking (PR=1.22; 1.04-1.43) and physical inactivity (PR=1.48; 1.41-1.55) but lower prevalence of hypertension (PR=0.90; 0.86-0.95), high cholesterol (PR=0.87; 0.79-0.95) and overweight/obesity (PR=0.46; 0.43-0.48). Mixed-Chinese had higher prevalence of CVD and worse CVD risk profiles compared with Chinese.

Conclusions
There are marked differences in the prevalence of CVD and risk factors among Chinese, mixed-Chinese and non-Chinese. The noticeable variations in CVD risk between Chinese and mixed-Chinese indicate that conventional classification of treating all Chinese as homogeneous could be misleading. More investigation into the health outcomes of mixed ancestry is warranted.