HIGH TOTAL AND CARDIOVASCULAR DISEASE MORTALITY IN ADULTS OF INDIAN DESCENT IN TRINIDAD, UNEXPLAINED BY MAJOR CORONARY RISK FACTORS

A prospective survey has been undertaken of a total community of 1343 men and 1149 women, aged 35-69 years at recruitment, living in Port-of-Spain, Trinidad. By comparison with adults of African descent, age-adjusted relative risks of death from all causes and from cardiovascular diseases were significantly increased in those of Indian origin (1·5 and 2·6, respectively) and reduced in those of mixed descent (0·5 and 0·3, respectively). Adults of European descent had an all-cause and cardiovascular mortality relative risk of 0·8 and 2·1, respectively. These ethnic differences in risk were not explained by systolic blood pressure, fasting blood glucose concentration, serum high-density lipoprotein or low-density lipoprotein concentration, or smoking habits. Differences in risk of cardiovascular death between Indian and European men seemed to be accounted for by the high prevalence of diabetes in Indians (19%) but other ethnic contrasts in mortality were unrelated to diabetes mellitus.