Dataset Information

Eligibility for cardiovascular risk screening among different ethnic groups: The HELIUS study.

ABSTRACT: BACKGROUND:Ethnic differences in the age-of-onset of cardiovascular risk factors may necessitate ethnic-specific age thresholds to initiate cardiovascular risk screening. Recent European recommendations to modify cardiovascular risk estimates among certain ethnic groups may further increase this necessity. AIMS:To determine ethnic differences in the age to initiate cardiovascular risk screening, with and without implementation of ethnic-specific modification of estimated cardiovascular risk. METHODS:We included 18,031 participants of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish and Moroccan background from the HELIUS study (Amsterdam). Eligibility for cardiovascular risk screening was defined as being eligible for blood pressure-lowering treatment, based on a combination of systolic blood pressure, estimated cardiovascular risk, and ethnic-specific conversion of estimated cardiovascular risk as recommended by European cardiovascular disease prevention guidelines. Age-specific proportions of eligibility were determined and compared between ethnic groups via logistic regression analyses. RESULTS:Dutch men reached the specified threshold to initiate cardiovascular risk screening (according to Dutch guidelines) at an average age of 51.5 years. Among ethnic minority men, this age ranged from 39.8 to 52.4. Among Dutch women, the average age threshold was 53.4. Among ethnic minority women, this age ranged from 36.8 to 49.1. Age-adjusted odds of eligibility were significantly higher than in the Dutch among all subgroups, except among Moroccan men. Applying ethnic-specific conversion factors had minimal effect on the age to initiate screening in all subgroups. CONCLUSIONS:Most ethnic minority groups become eligible for blood pressure-lowering treatment at a lower age and may therefore benefit from lower age-thresholds to initiate cardiovascular risk screening.

SUBMITTER: Perini W

PROVIDER: S-EPMC7357181 | biostudies-literature | 2020 Jul

REPOSITORIES: biostudies-literature

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Eligibility for cardiovascular risk screening among different ethnic groups: The HELIUS study.

Perini Wilco W Snijder Marieke B MB Agyemang Charles C Peters Ron Jg RJ Kunst Anton E AE van Valkengoed Irene Gm IG

European journal of preventive cardiology 20190725 11

<h4>Background</h4>Ethnic differences in the age-of-onset of cardiovascular risk factors may necessitate ethnic-specific age thresholds to initiate cardiovascular risk screening. Recent European recommendations to modify cardiovascular risk estimates among certain ethnic groups may further increase this necessity.<h4>Aims</h4>To determine ethnic differences in the age to initiate cardiovascular risk screening, with and without implementation of ethnic-specific modification of estimated cardiovas ...[more]

PMID: 31345055

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Project description:Sedentary behaviour is increasingly recognised as a health risk. While differences in this behaviour might help explain ethnic differences in disease profiles, studies on sedentary behaviour in ethnic minorities are scarce. The aim of this study was to compare the levels and the socio-demographic and lifestyle-related correlates of objectively measured sedentary time among five ethnic groups in Amsterdam, the Netherlands.Data were collected as part of the HELIUS study. The sample consisted of adults from a Dutch, Moroccan, African Surinamese, South-Asian Surinamese and Turkish ethnic origin. Data were collected by questionnaire, physical examination, and a combined heart rate and accelerometry monitor (Actiheart). Sedentary time was defined as waking time spent on activities of <1.5 metabolic equivalents. Ethnic differences in the levels of sedentary time were tested using ANOVA and ANCOVA analyses, while ethnic differences in the correlates of sedentary time were tested with interactions between ethnicity and potential correlates using general linear models. Associations between these correlates and sedentary time were explored using linear regression analyses stratified by ethnicity (pre-determined). All analyses were adjusted for gender and age.447 participants were included in the analyses, ranging from 73 to 109 participants per ethnic group. Adjusted levels of sedentary time ranged from 569 minutes/day (9.5 hours/day) for participants with a Moroccan and Turkish origin to 621 minutes/day (10.3 hours/day) in African Surinamese participants. There were no statistically significant differences in the levels or correlates of sedentary time between the ethnic groups. Meeting the physical activity recommendations (150 minutes/week) was consistently inversely associated with sedentary time across all ethnic groups, while age was positively associated with sedentary time in most groups.No statistically significant differences in the levels of objectively measured sedentary time or its socio-demographic and lifestyle-related correlates were observed among five ethnic groups in Amsterdam, the Netherlands.

Project description:Background:The increase of antimicrobial resistance, mainly due to increased antibiotic use, is worrying. Preliminary evidence suggests that antibiotic use differs across ethnic groups in the Netherlands, with higher use in people of non-Dutch origin. We aimed to determine whether appropriate knowledge and use of antibiotics differ by ethnicity and whether knowledge on antibiotics is associated with antibiotic use. Methods:We performed a cross-sectional study analyzing baseline data (2011-2015) from a population-based cohort (HELIUS study), which were linked to data from a health insurance register. We included 21,617 HELIUS participants of South-Asian Surinamese, African-Surinamese, Turkish, Moroccan, Ghanaian, and Dutch origin. Fifteen thousand seven participants had available prescription data from the Achmea Health Data-base (AHD) in the year prior to their HELIUS study visit. Participants were asked five questions on antibiotic treatment during influenza-like illness, pneumonia, fever, sore throat and bronchitis, from which higher versus lower antibiotic knowledge level was determined. Number of antibiotic prescriptions in the year prior to the HELIUS study visit was used to determine antibiotic use. Results:The percentage of individuals with a higher level of antibiotic knowledge was lower among all ethnic minority groups (range 57 to 70%) compared to Dutch (80%). After correcting for baseline characteristics, including medical conditions, first-generation African Surinamese and Turkish migrants received a significantly lower number of antibiotic prescriptions compared to individuals of Dutch origin. Only second-generation Ghanaian participants received more prescriptions compared to Dutch participants (aIRR 2.09, 95%CI 1.06 to 4.12). Higher level of antibiotic knowledge was not significantly associated with the number of prescriptions (IRR 0.92, 95%CI 0.85 to 1.00). Conclusions:Levels of antibiotic knowledge varied between ethnic groups, but a lower level of antibiotic knowledge did not correspond with a higher number of antibiotic prescriptions.

Project description:AimTo investigate whether items of the SF-12, widely used to assess health outcome in clinical practice and public health research, provide unbiased measurements of underlying constructs in different demographic groups regarding gender, age, educational level and ethnicity.MethodsWe included 23,146 men and women aged 18-70 of Dutch, South-Asian Surinamese, African Surinamese, Ghanaian, Turkish, or Moroccan origin from the HELIUS study. Both multiple group confirmatory factor analyses (MGCFA), with increasingly stringent model constraints (i.e. assessing Configural, Metric, Strong and Strict measurement invariance (MI)), and regression analysis were conducted to establish comparability of SF-12 items across demographic groups.ResultsMI regarding gender, age and education was tested in the ethnic Dutch group (N = 4,615). In each subsequent step of testing MI, change in goodness-of-fit measures did not exceed 0.010 (RMSEA) or 0.004 (CFI). Moreover, goodness-of-fit indices showed good fit for strict invariance models: RMSEA<0.055; CFI>0.97. Regarding ethnicity, RMSEA values of metric and subsequent models fell above 0.055, indicating violation of measurement invariance in factor loadings, thresholds and residual variances. Regression analysis revealed possible age-, education- and ethnicity-related DIF. Adjustment for this DIF had little impact on the magnitude of age and educational differences in physical and mental health, but ethnic inequalities in physical health-and to a lesser extent mental health-were reduced after DIF adjustment.ConclusionsWe found no evidence of violation of measurement invariance of the SF-12 regarding gender, age and educational level. If minor DIF would remain undetected in our MGCFA analyses, we showed that this would have negligible effect on the magnitude of demographic health inequalities. Regarding ethnicity, the SF-12 was not measurement invariant. After accounting for DIF, we observed a reduction of ethnic inequalities in health, in particular in physical health. Caution is warranted when comparing SF-12 scores across population groups with various ethnic backgrounds.

Project description:OBJECTIVE:To use newly available self-assigned ethnicity information to investigate variation in breast cancer screening uptake for women from the 16 specific ethnic groups within the broad Asian, Black and White groups that previous studies report. SETTING:National cancer screening programme services within London. PARTICIPANTS:655,516 female residents aged 50-69, invited for screening between March 2006 and December 2009. Ethnicity information was available for 475,478 (72.5%). White British women were the largest group (306,689, 46.8%), followed by Indian (34,687, 5.3%), White Other (30,053, 4.6%), Black Caribbean (25,607, 3.9%), White Irish (17,271, 2.6%), Black African (17,071, 2.6%) and Asian Other (10,579, 1.6%). OUTCOME MEASURES:Uptake for women in different ethnic groups aged 50-52 for a first call invitation to the programme, and for women aged 50-69 for a routine recall invitation after a previous mammography. Uptake is reported (1) for London overall, adjusted using logistic regression, for age at invitation, socioeconomic deprivation and geographical screening area, and (2) for individual areas, adjusted for age and deprivation. RESULTS:White British women attended their first call (67%) and routine recall (78%) invitations most often. Indian women were more likely to attend their first (61%) or routine recall (74%) than Bangladeshi women (43% and 61%, respectively), and Black Caribbean women were more likely than Black African women to attend first call (63% vs 49%, respectively) and routine recall (74% vs 64%, respectively). There was less variation between ethnic groups in some screening areas. CONCLUSIONS:Breast cancer screening uptake in London varies by specific ethnic group for first and subsequent invitations, with White British women being more likely to attend. The variation in the uptake for women from the same ethnic groups in different geographical areas suggests that collaboration about the successful engagement of services with different communities could improve uptake for all women.

Dataset Information

Eligibility for cardiovascular risk screening among different ethnic groups: The HELIUS study.

Publications

Eligibility for cardiovascular risk screening among different ethnic groups: The HELIUS study.

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