Ethnic trends in lipid tests in general practice

Background: South Asian migrants have a higher cardiovascular mortality than the indigenous population. Contributory factors may include a lower rate of cardiovascular risk assessment uptake and compliance. Aim: To compare rates of lipid testing, follow-up and patterns of dyslipidaemia in South Asian and non-South-Asian populations in Manchester. Design: Retrospective cross-sectional survey. Methods: Lipid requests from 14 general practices were analysed, using name recognition software to assign ethnicity. Results: Compared with non-South-Asians, the age-standardized rate of lipid testing in South Asians was similar in men at 12.1% (95% CI 11.6-12.6) vs. 11.2% (9.5-13.0), but higher in women at 18.6% (15.9-21.2) vs. 13.2% (12.6-13.7). Trends of cholesterol with repeat testing were similar in the two populations. However, South Asian women had lower mean levels of total cholesterol (5.50 vs. 5.68 mmol/l, p= 0.021), lower levels of HDL (1.20 vs. 1.46 mmol/l, p<0.001), an excess of hypertriglyceridaemia (1.62 vs. 1.45 mmol/l, p = 0.035) and a greater proportion with cholesterol >5.2 mmol/l combined with low HDL (43.1% vs. 20.2%, p=0.002). South Asian men had lower levels of total cholesterol (5.17 vs. 5.37 mmol/l, p = 0.048) and lower levels of HDL (1.07 vs. 1.64 mmol/l, p<0.001). There was no difference in the proportion of South Asians men and women with cholesterol <5.2 mmol/l combined with low HDL. Discussion: The rate of lipid testing and change in cholesterol levels with repeated testing did not differ between South Asian and non-South-Asian groups. The pattern of dyslipidaemia seen in this South Asian population, especially women, was different from that of the non-South-Asian population, with possible implications for cardiovascular risk assessment.