Psychosocial factors related to cardiovascular disease risk in UK South Asian men: a preliminary study.

OBJECTIVE To compare the exposure to psychosocial factors associated with cardiovascular risk in UK South Asian and white European men. DESIGN Interview study of 63 healthy UK South Asian and 42 white European men aged 35-75 years, randomly selected from a larger study group in West London. Interviews were administered in Punjabi and English. Measures of psychosocial and cardiovascular risk factors were obtained. SETTING Ealing Hospital, West London. RESULTS The South Asian men had lived in the UK for an average of 27.9 (SD 11.6) years, and had higher educational attainment than the white Europeans. Compared with the white Europeans, the South Asian men lived in significantly more crowded homes, experienced lower job control, greater financial strain, lower neighbourhood social cohesion and more racial harassment. They received less emotional support, and were more depressed and less optimistic on standard questionnaires. These men also had higher waist/hip ratios and were more sedentary, but there were no significant ethnic differences in biological risk factors. CONCLUSIONS South Asian men living in London showed a higher risk profile in psychosocial factors thought to contribute to cardiovascular disease risk. This preliminary investigation is consistent with the possibility that psychosocial adversity contributes to increased vulnerability to coronary heart disease in South Asians resident in the UK.

[1]  S. Verma,et al.  South Asians and cardiovascular risk: what clinicians should know. , 2006, Circulation.

[2]  F. Zitman,et al.  Dispositional optimism and the risk of cardiovascular death: the Zutphen Elderly Study. , 2006, Archives of internal medicine.

[3]  Mark Woodward,et al.  Excess risk of fatal coronary heart disease associated with diabetes in men and women: meta-analysis of 37 prospective cohort studies , 2005, BMJ : British Medical Journal.

[4]  C. Fischbacher,et al.  Self-Reported Work Strain is Lower in South Asian than European People: Cross-Sectional Survey , 2005, Ethnicity & health.

[5]  N. Chaturvedi,et al.  Heart disease epidemic in Pakistan: women and men at equal risk. , 2005, American heart journal.

[6]  S. Yusuf,et al.  Association of psychosocial risk factors with risk of acute myocardial infarction in 11 119 cases and 13 648 controls from 52 countries (the INTERHEART study): case-control study , 2004, The Lancet.

[7]  R. Baker,et al.  Do they look after their own? Informal support for South Asian carers. , 2004, Health & social care in the community.

[8]  C. Fischbacher,et al.  How physically active are South Asians in the United Kingdom? A literature review. , 2004, Journal of public health.

[9]  R. Bhopal,et al.  Glossary of terms relating to ethnicity and race: for reflection and debate , 2004, Journal of Epidemiology and Community Health.

[10]  Andrew Steptoe,et al.  The influence of low job control on ambulatory blood pressure and perceived stress over the working day in men and women from the Whitehall II cohort , 2004, Journal of hypertension.

[11]  Andrew Steptoe,et al.  How neighborhoods and physical functioning are related: The roles of neighborhood socioeconomic status, perceived neighborhood strain, and individual health risk factors , 2004, Annals of behavioral medicine : a publication of the Society of Behavioral Medicine.

[12]  R. Bhopal,et al.  Review of prevalence data in, and evaluation of methods for cross cultural adaptation of, UK surveys on tobacco and alcohol in ethnic minority groups , 2004, BMJ : British Medical Journal.

[13]  C. Fischbacher,et al.  Social networks and coronary heart disease risk factors in South Asians and Europeans in the UK , 2003, Ethnicity & health.

[14]  K. Matthews,et al.  Chronic stress burden, discrimination, and subclinical carotid artery disease in African American and Caucasian women. , 2003, Health psychology : official journal of the Division of Health Psychology, American Psychological Association.

[15]  M. Marmot,et al.  Influence of Socioeconomic Status and Job Control on Plasma Fibrinogen Responses to Acute Mental Stress , 2003, Psychosomatic medicine.

[16]  R. Bhopal,et al.  Is the blood pressure of South Asian adults in the UK higher or lower than that in European white adults? A review of cross-sectional data , 2002, Journal of Human Hypertension.

[17]  Raj Bhopal,et al.  Ethnic and socio-economic inequalities in coronary heart disease, diabetes and risk factors in Europeans and South Asians. , 2002, Journal of public health medicine.

[18]  J. Nazroo,et al.  Relation between racial discrimination, social class, and health among ethnic minority groups. , 2002, American journal of public health.

[19]  D. Thompson,et al.  The Experiences and Needs of Gujarati Hindu Patients and Partners in the First Month after a Myocardial Infarction , 2002, European journal of cardiovascular nursing : journal of the Working Group on Cardiovascular Nursing of the European Society of Cardiology.

[20]  N. Sattar,et al.  Relation of C-reactive protein to body fat distribution and features of the metabolic syndrome in Europeans and South Asians , 2001, International Journal of Obesity.

[21]  L. Chambless,et al.  Neighborhood of residence and incidence of coronary heart disease. , 2001, The New England journal of medicine.

[22]  J. Kooner,et al.  C-Reactive Protein, Insulin Resistance, Central Obesity, and Coronary Heart Disease Risk in Indian Asians From the United Kingdom Compared With European Whites , 2001, Circulation.

[23]  R. Bhopal What is the risk of coronary heart disease in South Asians? A review of UK research. , 2000, Journal of public health medicine.

[24]  E. Sonuga-Barke,et al.  The effect of extended family living on the mental health of three generations within two Asian communities. , 2000, The British journal of clinical psychology.

[25]  G. Veenstra,et al.  Social capital, SES and health: an individual-level analysis. , 2000, Social science & medicine.

[26]  A. Ong,et al.  Cultural values and intergenerational value discrepancies in immigrant and non-immigrant families. , 2000, Child development.

[27]  John C Chambers,et al.  Plasma homocysteine concentrations and risk of coronary heart disease in UK Indian Asian and European men , 2000, The Lancet.

[28]  K. Schenck-Gustafsson,et al.  Social Relations and the Metabolic Syndrome in Middle-Aged Swedish Women , 1999, Journal of cardiovascular risk.

[29]  S. Yusuf,et al.  Cardiovascular and cancer mortality among Canadians of European, south Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths. , 1999, CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne.

[30]  J. Blumenthal,et al.  Impact of psychological factors on the pathogenesis of cardiovascular disease and implications for therapy. , 1999, Circulation.

[31]  Michael W. Bridges,et al.  Optimism and rehospitalization after coronary artery bypass graft surgery. , 1999, Archives of internal medicine.

[32]  M. Marmot,et al.  Differences in biological risk factors for cardiovascular disease between three ethnic groups in the Whitehall II study. , 1999, Atherosclerosis.

[33]  J. Kooner Coronary heart disease in UK Indian Asians: the potential for reducing mortality , 1997, Heart.

[34]  S. Cohen,et al.  Social ties and susceptibility to the common cold. , 1997, JAMA.

[35]  K. Hunt,et al.  Psychological distress among British South Asians: the contribution of stressful situations and subcultural differences in the West of Scotland Twenty-07 Study , 1997, Psychological Medicine.

[36]  S. Raudenbush,et al.  Neighborhoods and violent crime: a multilevel study of collective efficacy. , 1997, Science.

[37]  S A Stansfeld,et al.  Low job control and risk of coronary heart disease in whitehall ii (prospective cohort) study , 1997, BMJ.

[38]  L. Berkman,et al.  Emotional Support and Survival after Myocardial Infarction , 1992, Annals of Internal Medicine.

[39]  E. Eaker,et al.  Myocardial infarction and coronary death among women: psychosocial predictors from a 20-year follow-up of women in the Framingham Study. , 1992, American journal of epidemiology.

[40]  C. Carver,et al.  Effects of optimism on psychological and physical well-being: Theoretical overview and empirical update , 1992, Cognitive Therapy and Research.

[41]  M. Marmot,et al.  Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians , 1991, The Lancet.

[42]  M. Lieberman,et al.  The stress process. , 1981, Journal of health and social behavior.

[43]  L. Radloff The CES-D Scale , 1977 .

[44]  L. Wilhelmsen,et al.  Coronary disease in relation to social support and social class in Swedish men. A 15 year follow-up in the study of men born in 1933. , 2004, European heart journal.

[45]  James Nazroo,et al.  Heart disease: an assessment of the importance of socioeconomic position , 2004 .

[46]  S. Harding Social mobility and self-reported limiting long-term illness among West Indian and South Asian migrants living in England and Wales. , 2003, Social science & medicine.

[47]  G. Evans,et al.  Socioeconomic status and health: the potential role of environmental risk exposure. , 2002, Annual review of public health.

[48]  H Hemingway,et al.  Psychosocial risk factors for coronary disease in White, South Asian and Afro-Caribbean civil servants: the Whitehall II study. , 2001, Ethnicity & disease.

[49]  R. Balarajan Ethnicity and variations in the nation's health. , 1995, Health trends.