PATTERN AND PREVALENCE OF DYSLIPIDEMIA AND OTHER CARDIOVASCULAR RISK FACTORS AMONG THE VARIOUS ETHNIC GROUPS OF TRINIDAD AND TOBAGO

Main Article Content

IDRIS SALEH
B. SHIVANANDA NAYAK

Abstract

Background: Dyslipidemia has for long been associated with the development of complications such as cardiovascular diseases (CVD) and is an important component of the metabolic syndrome. In addition, differences in the pattern of lipid derangements have been reported especially between people of the African descent and their counterpart of the South Asian descent.

Aim: To study the pattern and prevalence of dyslipidemia and other cardiovascular risk factors among the various ethnic groups in Trinidad and Tobago.

Materials and Methods: This study comprises of 968 subjects and 10mL of blood sample was collected from each after an overnight fasting of 10–12 hours. Plasma and sera were used to analyse glucose, total cholesterol, triglycerides, high density cholesterol (HDL-C), very low density lipoprotein (VLDL), and low density lipoprotein (LDL). Anthropometric indices such as height, weight, waist circumference, age, gender, education, occupation, ethnicity and medical history including medications were obtained from each subject.

Results: There were differences in body mass index (BMI), systolic blood pressure, blood glucose, triglycerides and very low-density lipoprotein cholesterol amongst the various ethnic groups (p < 0.05). However, levels of HDL-C were similar among the various ethnicities although patients of the South Asian descent tend to have a trend towards none-significantly higher levels of HDL-C compared with other ethnic groups (p > 0.05).

Conclusion: The study has emphasized the well-established important disparity in lipid profiles amongst the people of various ethnic groups especially amongst patients with chronic noncommunicable disease (CNCD) in Trinidad and Tobago.

Keywords:
Cardiovascular, Caribbean, chronic noncommunicable diseases, dyslipidemia, epigenetic, socioeconomic.

Article Details

How to Cite
SALEH, I., & NAYAK, B. S. (2020). PATTERN AND PREVALENCE OF DYSLIPIDEMIA AND OTHER CARDIOVASCULAR RISK FACTORS AMONG THE VARIOUS ETHNIC GROUPS OF TRINIDAD AND TOBAGO. Journal of Disease and Global Health, 13(1), 28-37. Retrieved from https://ikprress.org/index.php/JODAGH/article/view/5731
Section
Original Research Article

References

Yusuf S, Hawken S, Ounpuu S, Dans T, Avezum A, Lanas F, McQueen M, Budaj A, Pais P, Varigos J, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART study): case-control study. Lancet. 2004;364:937-952.

Akinboboye O, Idris O, Akinkugbe O. Trends in coronary artery disease and associated risk factors in sub-Saharan Africans. J Hum Hypertens. 2003;17(6):381-387.

Zoratti R. A review on ethnic difference in plasma triglycerides and high-density-lipoprotein cholesterol: is the lipid pattern the key factor for the low coronary heart disease rate in people of African origin? Eur J Epidemiol. 1998;14(1):9-21.

Chobanian AV, Alexander RW. Exacerbation of atherosclerosis by hypertension: potential mechanisms and clinical implications. Arch Intern Med. 1996;156(17):1952-56.

Karthikeyan G, Teo KK, Islam S, McQueen MJ, Pais P, Wang X, Sato H, Lang CC, Sitthi-Amorn C, Pandey MR, et al. Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. J Am Coll Cardiol. 2009;53:244-253.

Cappuccio FP. Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian Origin. J Hum Hypertens. 1997;11(9):571-576.

Gupta R, Gupta VP, Sarna M, Bhatnagar S, Thanvi J, Sharma V, Singh AK, Gupta JB, Kaul V. Prevalence of coronary heart disease and risk factors in an urban Indian population: Jaipur Heart Watch-2. Indian Heart J. 2002;54:59–66.

Sekhri T, Kanwar RS, Wilfred R, Chugh P, Chhillar M, Aggarwal R, Sharma YK, Sethi J, Sundriyal J, Bhadra K, et al. Prevalence of risk factors for coronary artery disease in an urban Indian population. BMJ Open. 2014;4:e005346.

Bhardwaj S, Misra A, Misra R, Goel K, Bhatt SP, Rastogi K, Vikram NK, Gulati S. High prevalence of abdominal, intra-abdominal and subcutaneous adiposity and clustering of risk factors among urban Asian Indians in North India. PLoS One. 2011;6:e24362.

Gopinath N, Chadha SL, Jain P, Shekhawat S, Tandon R. An epidemiological study of obesity in adults in the urban population of Delhi. J Assoc Physicians India. 1994;42:212-215.

Misra A, Pandey RM, Devi JR, Sharma R, Vikram NK, Khanna N. High prevalence of diabetes, obesity and dyslipidaemia in urban slum population in northern India. Int J Obes Relat Metab Disord. 2001;25:1722-1729.

Wilkinson RG, Pickett KE. Income inequality and population health: a review and explanation of the evidence. Soc Sci Med. 2006;62:1768-84.

Kuzawa CW, Sweet E. Epigenetics and the embodiment of race: developmental origins of US racial disparities in cardiovascular health. Am J Hum Biol 2009; 21:2-15.

Kuzawa CW, Thayer ZM. Timescales of human adaptation: the role of epigenetic processes. Epigenomics 2011;3:221-34.

De la Cova C. Race, health and disease in 19th-century born males. Am J Phys Anthropol. 2011;144:526-37.

Subramanian SV, Smith GD, Subramanyam M. Indigenous health and socioeconomic status in India. PLoS Med. 2006;3:421.

Marmot MG, Stansfeld S, Patel C, North F, Head J, White I, et al. Health inequalities among British civil servants: the Whitehall II study. Lancet. 1991;337:1387-93.

McMillen IC, MacLaughlin SM, Muhlhausler BS, Gentili S, Duffield JL, Morrison JL. Developmental origins of adult health and disease: the role of periconceptional and foetal nutrition. Basic Clin Pharmacol Toxicol. 2008;102:82-9.

Bateson P, Barker D, Clutton-Brock T, Deb D, D’Udine B, Foley RA, et al. Developmental plasticity and human health. Nature. 2004;430:419-21.

Burdge GC, Lillycrop KA. Nutrition, epigenetics and developmental plasticity: implications for understanding human disease. Annu Rev Nutr. 2010;30:315-39.

Choi SW, Friso S. Epigenetics: A new bridge between nutrition and health. Adv Nutr: An International Review Journal. 2010;1:8-16.

Thompson RF, Fazzari MJ, Niu H, Barzilai N, Simmons RA, Greally JM. Experimental intrauterine growth restriction induces alterations in DNA methylation and gene expression in pancreatic islets of rats. J Biol Chem. 2010;285:15111-8.

Zeisel SH. Epigenetic mechanisms for nutrition determinants of later health outcomes. Am J Clin Nutr. 2009;89:1488-93.

Evans GW, English K. The environment of poverty: multiple stressor exposure, psychophysiological stress and socioemotional adjustment. Child Dev. 2002;73:1238-48.

Baum A, Garofalo JP, Yali AM. Socioeconomic status and chronic stress: does stress account for SES effects on health? Ann N Y Acad Sci. 1999;896:131-44.

Williams D, Mohammed S. Discrimination and racial disparities in health: evidence and needed research J Behav Med. 2009;32:20-47.

Yoo HC, Gee GC, Takeuchi D. Discrimination and health among Asian American immigrants: disentangling racial from language discrimination. Soc Sci Med. 2009;68:726-32.

Sheridan LP. Islamophobia pre- and post-September 11th. 2001. J Interpers Violence 2006;21:317-36.

Oppedal B, Røysamb E, Heyerdahl S. Ethnic group, acculturation and psychiatric problems in young immigrants. J Child Psychol Psychiatry. 2005;46:646-60.

Wamala S, Bostrom G, Nyqvist K. Perceived discrimination and psychological distress in Sweden.Br J Psychiatry. 2007;190:75-6.

Fragou D, Fragou A, Kouidou S, Njau S, Kovatsi L. Epigenetic mechanisms in metal toxicity. Toxicol Mech Methods. 2011;21:343-52.

Lee DH, Jacobs DR Jr, Porta M. Hypothesis: a unifying mechanism for nutrition and chemicals as lifelong modulators of DNA hypomethylation. Environ Health Perspect. 2009;117:1799-802.

Rusiecki JA, Baccarelli A, Bollati V, Tarantini L, Moore LE, Bonefeld-Jorgensen EC. Global DNA hypomethylation is associated with high serum-persistent organic pollutants in Greenlandic Inuit. Environ Health Perspect. 2008;116:1547-52.

Yauk C, Polyzos A, Rowan-Carroll A, Somers CM, Godschalk RW, Van Schooten FJ, et al. Germ-line mutations, DNA damage and global hypermethylation in mice exposed to particulate air pollution in an urban/industrial location. Proc Natl Acad Sci USA. 2008;105:605-10.

Perera F, Tang Wy, Herbstman J, Tang D, Levin L, Miller R, et al. Relation of DNA methylation of 5'-CpG island of ACSL3 to transplacental exposure to airborne polycyclic aromatic hydrocarbons and childhood asthma. PLoS ONE. 2009;4:4488.

Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R. et al. European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (Constituted by representatives of nine societies and by invited experts). Eur Heart J. 2007;28(19):2375-2414.

Third Report of the National Cholesterol Education Program (NCEP) Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III) final report. Circulation. 2002;106(25):3143-3421.

Ford ES, Li C, Zhao G, Pearson WS, Mokdad AH. Hypertriglyceridemia and its pharmacologic treatment among US adults. Arch Intern Med. 2009;169:572-578.

Steyn K, Sliwa K, Hawken S, Commerford P, Onen C, Damasceno A. et al. Risk factors associated with myocardial infarction in Africa: the INTERHEART Africa study. Circulation. 2005;112(23):3554-3561.

Rizzo M, Otvos J, Nikolic D, Montalto G, Toth PP, Banach M. Subfractions and subpopulations of HDL: an update. Curr Med Chem. 2014;21:2881-91.

Bays HE, Jones PH, Brown WV, Jacobson TA. National Lipid Association Annual Summary of Clinical Lipidology 2015. J Clin Lipidol. 2014;8:S1-S6.

Karthikeyan G, Teo KK, Islam S, McQueen MJ, Pais P, Wang X, Sato H, Lang CC, Sitthi-Amorn C, Pandey MR, et al. Lipid profile, plasma apolipoproteins, and risk of a first myocardial infarction among Asians: an analysis from the INTERHEART Study. J Am Coll Cardiol. 2009;53:244-253.

Nguyen TT, Ellefson RD, Hodge DO, Bailey KR, Kottke TE, Abu-Lebdeh HS. Predictive value of electrophoretically detected lipoprotein(a) for coronary heart disease and cerebrovascular disease in a community-based cohort of 9936 men and women. Circulation. 1997;96:1390-1397.

Mooser V, Scheer D, Marcovina SM, Wang J, Guerra R, Cohen J, Hobbs HH. The Apo(a) gene is the major determinant of variation in plasma Lp(a) levels in African Americans. Am J Hum Genet. 1997;61:402-417.

Boerwinkle E, Leffert CC, Lin J, Lackner C, Chiesa G, Hobbs HH. Apolipoprotein(a) gene accounts for greater than 90% of the variation in plasma lipoprotein(a) concentrations. J Clin Invest. 1992;90:52-60.

Kostner GM, Czinner A, Pfeiffer KH, Bihari-Varga M. Lipoprotein (a) concentrations as risk indicators for atherosclerosis. Arch Dis Child. 1991;66:1054-1056.

Isser HS, Puri VK, Narain VS, Saran RK, Dwivedi SK, Singh S. Lipoprotein (a) and lipid levels in young patients with myocardial infarction and their first-degree relatives. Indian Heart J. 2001;53:463-466.

Bhatnagar D, Anand IS, Durrington PN, Patel DJ, Wander GS, Mackness MI, Creed F, Tomenson B, Chandrashekhar Y, Winterbotham M. Coronary risk factors in people from the Indian subcontinent living in West London and their siblings in India. Lancet. 1995;345:405-409.

Harris R, Tobias M, Jeffreys M, Waldegrave K, Karlsen S, Nazroo J. Racism and Health: the relationship between experience of racial discrimination and health in New Zealand. Soc Sci Med. 2006;63:1428-41.

DeSantis AS, Adam EK, Doane LD, Mineka S, Zinbarg RE, Craske MG. Racial/ethnic differences in cortisol diurnal rhythms in a community sample of adolescents. J Adolesc Health. 2007;41:3-13.

Palaniappan L, Anthony MN, Mahesh C, Elliott M, Killeen A, Giacherio D, Rubenfire M. Cardiovascular risk factors in ethnic minority women aged & amp lt; or =30 years. Am J Cardiol. 2002;89:524-529.

Kamath SK, Hussain EA, Amin D, Mortillaro E, West B, Peterson CT, Aryee F, Murillo G, Alekel DL. Cardiovascular disease risk factors in 2 distinct ethnic groups: Indian and Pakistani compared with American premenopausal women. Am J Clin Nutr. 1999;69:621-631.

Anand SS, Enas EA, Pogue J, Haffner S, Pearson T, Yusuf S. Elevated lipoprotein(a) levels in South Asians in North America. Metabolism. 1998;47:182-184.

Musha H, Hayashi A, Kida K, Takahashi E, Suzuki K, Kawasaki K, et al. Gender difference in the level of high-density lipoprotein cholesterol in elderly Japanese patients with coronary artery disease. Intern Med. 2006;45:241-245.

Davis CE, Williams DH, Oganov RG, Tao SC, Rywik SL, Stein Y, et al. Sex difference in high density lipoprotein cholesterol in six countries. Am J Epidemiol. 1996;143:1100-1106.

Klimis D, Gnardellis C, Trichopoulou A. Gender differences in blood lipids in a Greek island population: the EPIC study. Nutr Res. 2000;20:35-45.

Rossouw JE. Hormones, genetic factors, and gender differences in cardiovascular disease. Cardiovasc Res. 2002;53:550-557.