Chiu et al., CMAJ 2010 Do ethnic groups living in Ontario differ in their cardiovascular risk profiles? Maria Chiu, MSc, PhD Candidate Inst. of Medical Science, University of Toronto Inst. for Clinical Evaluative Sciences

Chiu et al., CMAJ 2010 Citation: Comparison of cardiovascular risk profiles among ethnic groups using population health surveys between 1996 and 2007 Maria Chiu, Peter C. Austin, Douglas G. Manuel, and Jack V. Tu CMAJ 2010 Apr. DOI: /cmaj

Chiu et al., CMAJ 2010 Acknowledgment: We thank all the participants of Statistics Canada’s NPHS and CCHS, and the staff from Statistics Canada who assisted in the collection and management of the survey data. Funding Sources: Heart and Stroke Foundation of Ontario CIHR Canada Graduate Scholarship Canadian Cardiovascular Outcomes Research Team

Chiu et al., CMAJ 2010 To compare the prevalence of a. CVD risk factors (e.g. smoking, diabetes, etc.) b. Heart disease c. Stroke in the 4 largest ethnic groups in Ontario: White, Chinese, South Asian, andBlack Study objective

Chiu et al., CMAJ 2010 METHODS

Chiu et al., CMAJ 2010 Methods National Population Health Survey (NPHS) and Canadian Community Health Survey (CCHS) Data source Population-based cross-sectional surveys conducted by Statistics Canada Provide timely, reliable estimates of health determinants, health status and health system utilization Include: Aged 12+ in private dwellings Exclude: People on Indian Reserves, Canadian Forces Bases

Chiu et al., CMAJ 2010 Q: People living in Canada come from many different cultural and racial backgrounds. Are you: White Chinese South Asian (e.g. East Indian, Pakistani, Punjabi, Sri-Lankan) Black etc… Study variables Ethnic/racial background

Chiu et al., CMAJ 2010 Study variables CVD risk factors Current smoking Current smoking Obesity Diabetes Diabetes Hypertension Psychosocial stress Inadequate fruit/vegetables Inadequate physical activity Inadequate physical activity Non-regular alcohol intake Non-regular alcohol intake CVD Heart disease Heart disease Stroke Stroke

Chiu et al., CMAJ 2010 Methods Statistical analysis Statistical software: SAS v9.1 Statistical software: SAS v9.1 Age-sex standardized prevalence of CVD risk factors, heart disease, stroke Age-sex standardized prevalence of CVD risk factors, heart disease, stroke Standard population: 2001 Ontario census Standard population: 2001 Ontario census All estimates weighted by sample weights from Statistics Canada All estimates weighted by sample weights from Statistics Canada Bootstrap method for variance estimation for 95% CI and P values Bootstrap method for variance estimation for 95% CI and P values

Chiu et al., CMAJ 2010 RESULTS

Chiu et al., CMAJ 2010 Results WhiteChineseS. AsianBlack TOTAL N = Study sample size, NPHS/CCHS

Chiu et al., CMAJ 2010 Results Sociodemographic characteristics (%)

Chiu et al., CMAJ 2010 Risk Factors

Chiu et al., CMAJ 2010 Results Age-sex standardized prevalence (%) 1. Major CV risk factors

Chiu et al., CMAJ 2010 Results Age-sex standardized prevalence (%) 1. Major CV risk factors—by sex

Chiu et al., CMAJ 2010 Results Age-sex standardized prevalence (%) 2. Other CV risk factors

Chiu et al., CMAJ 2010 Results Age standardized prevalence (%) 2. Other cardiovascular risk factors – by sex

Chiu et al., CMAJ 2010 Heart disease and Stroke

Chiu et al., CMAJ 2010 Results Prevalence of heart disease (%) 95% CI * * * P<0.05

Chiu et al., CMAJ 2010 Results Prevalence of stroke (%) 95% CI * P<0.05 *

Chiu et al., CMAJ 2010 CONCLUSION

Chiu et al., CMAJ 2010 Discussion Striking differences in cardiovascular risk profiles across 4 major ethnic groups in Ontario Striking differences in cardiovascular risk profiles across 4 major ethnic groups in Ontario Every group can improve their cardiovascular health Every group can improve their cardiovascular health Chinese: physical inactivity Chinese: physical inactivity South Asian: diabetes, hypertension, physical inactivity South Asian: diabetes, hypertension, physical inactivity White: smoking, obesity, psychosocial stress White: smoking, obesity, psychosocial stress Black: diabetes, hypertension, obesity (females), physical inactivity (females) Black: diabetes, hypertension, obesity (females), physical inactivity (females) Help identify priorities for development of ethnic-specific cardiovascular disease-prevention programs Help identify priorities for development of ethnic-specific cardiovascular disease-prevention programs