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Registration on a primary care disease register is a necessary first step for the provision of systematic care for ischaemic heart disease (IHD). We examined whether there is any potential bias in IHD registration based upon the ethnic origin of the patient.'Observed' rates of ischaemic heart disease registration from 12 general practices in Bristol were contrasted with national 'expected' rates derived from the Health Survey for England, 1999, with the aim of comparing rates of registration between patients whose countries of origin were South Asian and non-South Asian. Ethnicity was classified by the patients' surname. Data were stratified by age, sex and ethnicity.Overall, no major differences in 'observed' and 'expected' rates of registration between South Asian and non-South Asians were observed. In general, however, 'observed' rates were lower than the 'expected' rates for both groups.We found no overall bias in IHD registration based upon the patient's ethnic origin but we did observe generally low rates of IHD registration overall.

The predictive power of height for future ischaemic heart disease (IHD) was examined in 4860 men from two communities in South Wales and the West of England. At follow-up, men in the shortest fifth of the height distribution had experienced twice as many incident IHD events (fatal and non-fatal myocardial infarction) as was the case for men from the tallest fifth. Adjustment for age, social class and smoking habit failed to alter these relationships significantly. In the data from South Wales, determinants of height were examined; birth rank and number of siblings showed a trend with height. This trend was found only in men whose fathers were manual workers and may be related to inadequate nutrition in the higher birth ranks and larger families. These results support the suggestion that early childhood factors may be relevant to IHD in middle age and possible mechanisms are discussed.

A collaborative study was carried out to compare AOAC method 2.147-2.150 for determining sodium in fertilizers with the atomic absorption spectrophotometric (AAS) method. Twelve synthetic NPK samples, 6 pairs of blind duplicates (0.06-8.5% Na), were sent to 22 collaborators; a total of 13 sets of results were received and evaluated by the modified matched pairs technique. The AAS method showed better performance in samples with low sodium content and high potassium content. The AAS method has been adopted official first action for determining sodium in fertilizers.

Baker I A (Bristol and Weston Health Authority, 10 Marlborough St Bristol BS1 3NP, UK), Sweetnam P M, Yarnell J W G, Bainton 0 and Elwood P C Haemostatic and other risk factors for ischaemic heart disease and social class: evidence from the Caerphilly and Speedwell studies. International Journal ot Epidemiology1988,17: 759-765. There are marked associations between social class and mortality from ischaemic heart disease (IHD). Using data from the Caerphilly and Speedwell Collaborative Heart Disease Studies the relationships between a number of known risk factors for IHD and social class are explored. The overall conclusions are that lipids and obesity are unlikely to play any part in explaining sodal differences in ischaemic heart disease. Blood pressure, particularly stystolic pressure, could be involved but the two data sets are inconsistent and associations are only shown in Speedwell. There are marked differences in the haemostatic related variables in the various social classes and the pattern of these is similar in Caerphilly and Speedwell. It is possible therefore that the class pattern of IHD is generated, in part at least by differences in haemostatic mechanisms. These differences in haemostatic function are almost entirely due to the large social class differences in smoking habit It is possible therefore that the class differences in IHD result from differences in smoking habit

A total population survey of serum lipoprotein concentrations was undertaken in an urban community in Port-of-Spain, Trinidad, and the results compared with rural survey on the same island and a study of healthy adults in Bristol, England. Lipoproteins were separated with identical techniques and lipid determinations made in a common laboratory. In Trinidad, response rates for men and women were 93 and 88% respectively in the urban survey, and 89% in the smaller rural study. Mean concentration of HDL cholesterol was significantly lower and LDL cholesterol significantly higher in urban men than rural men. No urban-rural differences were found in women. In urban men under 55 years, HDL and LDL cholesterol concentrations were similar in Port-of-Spain and Bristol while VLDL triglyceride was relatively high in Trinidad. Distinct ethnic differences in lipoprotein concentrations were found in Trinidad. Indian men and women tended to have a low HDL cholesterol relative to other ethnic groups, while African men and women were characterized by relatively low concentrations of LDL cholesterol and VLDL triglyceride. The reduction in HDL cholesterol of Indian men appeared to be due mainly to a relatively low HDL3 concentration. The results are consistent with reported regional, sex and ethnic differences in CHD incidence in Trinidad, and accord with statistics which show cardiovascular disease to have emerged as the major cause of death in this community.