Association of physical activity, smoking, and alcohol intake with CVD-related hospital discharge in people of European, South Asian, or African descent

Background: It is unclear whether the beneficial effects of certain lifestyle factors are equally strong in ethnic minority populations in Europe. This study explores whether this association of physical activity, smoking, and alcohol intake with cardiovascular disease (CVD)-related hospital discharge differs among South Asian Surinamese, African Surinamese, or Dutch descent living in the Netherlands. Design: Prospective cohort. Methods: We obtained baseline data from 370 South Asian, 689 African, and 567 Dutch participants (aged 35–60 years) of the SUNSET study (2001⊟2003). Follow up ended in December 2007. We used Cox proportional hazards models to study the associations of lifestyle factors with CVD-related hospital discharge. Results: In the overall study population, low amount of physical activity (hazard ratio, HR 1.88, 95% CI 1.23⊟2.86), current smoking (HR 1.63, 95% CI 1.20⊟2.22), and nondrinking (HR 1.52, 95% CI 1.04⊟2.23) were associated with CVD-related hospital admission. There was no statistically significant effect of ethnicity on these associations. For instance, the adjusted HR for CVD-related hospital discharge regarding a low amount of physical activity was 2.77 (95% CI 1.31⊟5.87) for Africans, 1.53 (95% CI 0.76⊟3.05) for South Asians, and 1.55 (95% CI 0.73⊟3.30) for the Dutch. The p-value for ethnicity by lifestyle interaction was 0.41. Conclusion: We did not find a different association across ethnic groups of South Asian Surinamese, African Surinamese, or Dutch descent between physical activity, smoking, and alcohol intake and 5-year hazard of a CVD-related hospital discharge. We recommend confirmation in multiethnic studies in other contexts.