Some recent advances in non-communicable diseases in the tropics. 3. Coronary heart disease and associated characteristics in a tropical developing community.

Vital statistics indicate that cardiovascular disorders are now major causes of morbidity and mortality in many Caribbean communities. In Trinidad and Tobago, for example, the death rate from myocardial infarction is now similar to that in the UK and USA. In a 10-year prospective survey of 1386 men aged 35 to 69 years at entry, who belonged to a defined community in Port-of Spain, Trinidad, serum high-density (HDL) and low-density (LDL) lipoprotein cholesterol concentrations were very similar to those found by the same methods in Bristol, England. The age-adjusted incidence of first coronary heart disease (CHD) events in men clinically free of the disease at recruitment (per 1000 person-years) was 16.4 in men of Indian descent, 6.8 in those of African origin, 6.2 in those of European origin, and 2.4 in men of mixed descent (the contemporaneous figure for Bristol was about 12/1000 person-years). Serum HDL and LDL cholesterol concentrations were strong and independent predictors of CHD in Trinidad, as they are in temperate climes. With effective control of tropical infectious diseases, and adoption of western patterns of consumerism, tropical developing communities will rapidly acquire the CHD risk factor status once more or less exclusive to developed populations in more temperate climes.