Bhopal R
Department of Epidemiology and Public Health, School of Health Sciences, University of Newcastle upon Tyne.
J Public Health Med. 2000 Sep;22(3):375-85. doi: 10.1093/pubmed/22.3.375.
The aim of this study was to systematically review the evidence that coronary heart disease risk is higher in South Asians than in comparative 'white' populations, particularly seeking studies of incidence.
A systematic literature review was carried out using a personal research literature collection, MEDLINE 1966-1998 and citations from references.
Of 19 studies, none reported disease incidence. Most studies reported prevalence, mortality rates or health care utilization data. Most studies were on people born on the Indian subcontinent, thus omitting the British-born. Several did not report on women. The strongest evidence of an excess of CHD in South Asians came from mortality data comparing those born in the Indian subcontinent with the whole population of England and Wales. In South Asians coronary heart disease is common and important, but neither the actual disease rates nor the excess risk in relation to the 'white' population are known. Both prevalence and mortality data suggested that the frequency of coronary heart disease in Indians, Pakistanis and Bangladeshis differed.
Estimates of South Asians' excess risk of coronary heart disease are imprecise and may be too high (if there are data errors) or too low (for comparison with the general population blunts ethnic variations). South Asians are a heterogeneous group yet most studies of CHD report on Bangladeshis, Indians and Pakistanis combined. Indians probably have less CHD than Bangladeshis and Pakistanis. Cohort studies on CHD in South Asians are needed and these should be designed so that data can be combined for future systematic reviews.
本研究旨在系统回顾有关南亚人患冠心病风险高于对照“白人”人群的证据，尤其关注发病率研究。
通过个人研究文献收集、检索1966 - 1998年的MEDLINE以及参考文献引用进行系统的文献回顾。
19项研究中，无一报告疾病发病率。多数研究报告的是患病率、死亡率或医疗保健利用数据。多数研究针对出生在印度次大陆的人群，因而遗漏了在英国出生的人群。有几项研究未报告女性情况。南亚人冠心病过多的最有力证据来自将出生在印度次大陆的人与英格兰和威尔士全体人口进行比较的死亡率数据。在南亚人中，冠心病常见且重要，但实际发病率以及与“白人”人群相比的额外风险均未知。患病率和死亡率数据均表明，印度人、巴基斯坦人和孟加拉国人患冠心病的频率存在差异。
对南亚人冠心病额外风险的估计并不精确，可能过高（如果存在数据错误）或过低（因为与总体人群比较会掩盖种族差异）。南亚人是一个异质性群体，但多数冠心病研究报告的是孟加拉国人、印度人和巴基斯坦人的综合情况。印度人患冠心病的情况可能比孟加拉国人和巴基斯坦人少。需要开展南亚人冠心病队列研究，且研究设计应便于未来系统回顾时合并数据。
