Marked differences in cardiovascular risk profiles in middle-aged and older Chinese residents: Evidence from a large Australian cohort

Abstract Background Although Chinese form the largest non-English speaking group in Australia, cardiovascular disease (CVD) risk profiles among Chinese Australians have not been comprehensively examined, nor has the effect of mixed-Chinese ethnicity been adequately explored. This study is to investigate cardiovascular risk among Chinese, mixed-Chinese and non-Chinese Australians. 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 = 1062) 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 major 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 sociodemographic characteristics. Results Compared with non-Chinese Australians, Chinese had lower prevalence of CHD (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 three groups. 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.