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Abstract
Aims. To compare cardiovascular risk factors among the major Pacific Island communities participating in a New Zealand multicultural workforce survey.
Method. There were 650 employed Pacific Island participants (Samoan 357, Cook Islands 177, Tongan 71, Niuean 45), aged 40-65 years, who were interviewed in a work-based, cross-sectional survey. During an oral glucose tolerance test, blood samples were collected for determination of blood glucose and serum lipids. Participants provided information on smoking and leisure time physical activity. Blood pressure, weight and height were measured and body mass index calculated. Ten-year risk of cardiovascular disease was calculated using equations from the Framingham study.
Results. Among men, their ten-year risk of a cardiovascular event was similar for the four communities compared (range 11.5% to 13.2%). However, individual risk factors did vary between the ethnic groups with Cook Island men having significantly higher total cholesterol, blood pressure and urinary microalbumin than other Pacific Island ethnic groups, while Tongan men were more likely to smoke and had lower HDL levels than other groups. Among women, Samoan and Cook Island participants had significantly higher ten-year cardiovascular risk scores (5.7%) than Niuean (4.4%) and Tongan (3.7%), due primarily to elevated total cholesterol levels.
Conclusion. Cardiovascular risk factor levels vary between Pacific Islands communities in New Zealand. Targeted interventions to specific Pacific communities may be more beneficial than the current homogeneous prevention strategy applied to all communities.
NZ Med J 2000; 113: 3-5
Pacific Island people in New Zealand have high rates of coronary heart disease, hypertension and diabetes compared with Europeans.1"4 The reasons for the high rates of cardiovascular disease in Pacific Island People are unclear. Ethnic differences in serum total cholesterol, which is a major risk factor of coronary heart disease among Caucasian populations, do not appear to be involved since Pacific Islands and Maori people have levels similar to Europeans.5 Cohort studies by Prior have shown that serum cholesterol in Pacific people is inversely related to total mortality (and probably also to cardiovascular mortality).6 In contrast, the same studies by Prior have identified systolic blood pressure as an important predictor of total mortality. High-density lipoprotein (HDL)-cholesterol could also be important, as HDL-cholesterol is lower in Pacific Islands and Maori people compared with Europeans.5
Lifestyle risk factors, such...