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ABSTRACT
AIM: In Aotearoa, New Zealand, cardiovascular disease (CVD) burden is greatest among Indigenous Māori, Pacific and Indian people. The aim of this study was to describe CVD risk profiles by ethnicity.
METHODS: We conducted a cross-sectional analysis of a cohort of people aged 35-74 years who had a CVD risk assessment in primary care between 2004 and 2016. Primary care data were supplemented with linked data from regional/national databases. Comparisons between ethnic groups were made using age-adjusted summaries of continuous or categorical data.
RESULTS: 475,241 people (43% women) were included. Fourteen percent were Māori, 13% Pacific, 8% Indian, 10% Other Asian and 55% European. Māori and Pacific people had a much higher prevalence of smoking, obesity, heart failure, atrial fibrillation and prior CVD compared with other ethnic groups. Pacific and Indian peoples, and to a lesser extent Māori and Other Asian people, had markedly elevated diabetes prevalence compared with Europeans. Indian men had the highest prevalence of prior coronary heart disease.
CONCLUSIONS: Māori and Pacific people experience the most significant inequities in exposure to CVD risk factors compared with other ethnic groups. Indians have a high prevalence of diabetes and coronary heart disease. Strong political commitment and cross-sectoral action to implement effective interventions are urgently needed.
Cardiovascular diseases (including diabetes) account for 17% of health loss among people living in Aotearoa, New Zealand.1 There have been considerable reductions in the incidence and mortality of cardiovascular disease (CVD) in New Zealand over the past 20 years through good prevention and access to treatment.1-3 For ischaemic heart disease (IHD) and stroke, hospitalisation and mortality rates have fallen in all demographic groupings including gender and ethnicity, with a smaller decline in IHD rates in Pacific peoples than other ethnicities6 and a larger decline in stroke rates for Indian people than other ethnic groups (unpublished). However, the burden of CVD is unevenly distributed across New Zealand by ethnicity, with Māori, Pacific and Indian people experiencing a greater burden of this condition than other groups.4-8 This increased burden of CVD is one of the main drivers behind the 6-7 year lower life expectancy experienced by Māori and Pacific people at birth compared with other groups in this country.4'5 There is a need for continued focus on CVD given...