Milan, ItalyLizzy Brewster, MD PhD, from the Academic Medical Center in Amsterdam is a doctor and medical research scientist whose heritage is from Surinam, and this inspired her to work on a unique study which has found that ethnicity is-by a large margin-more significant in determining cardiovascular risks, according to results she presented here at the hypertension congress.

“Ethnicity, and not so much the risk scores that people calculate, is a major determinant of cardiovascular mortality-especially South Asian and Black ethnicity,” she said in an interview.

Her tri-ethnic study of lipid profiles involved communities from Surinam-a country which, remarkably, experienced the migration of half of its population to the Netherlands and thus created arms of an unplanned experiment looking at the impact of diet and lifestyle changes on human health.

Surinamese with South Asian ethnicity adopted European diets and lifestyles and-the study found-developed adverse lipid profiles, with low HDL and high triglycerides, and also experienced greatly increased mortality form cardiovascular disease as compared with ethnically similar populations remaining in Surinam.

Black Surinamese migrants to the Netherlands, on the other hand, were exposed to similar diets and adopted lifestyles as the South Asians, yet were found to have favourable lipids. But they too experienced high rates of cardiovascular disease.

Black and South Asian Migrants were equally overweight. But only the white Netherlands population studied by the Amsterdam group were found to have cardiovascular risks and mortality in keeping with the usual score systems found in doctors’ offices.

And the take home message is that you have to pay great regard to ethnicity in any patient when you are interpreting the clinical and prognostic implications of lipid profiles, Dr Brewster said: “What I always tell colleagues-as a practical rule-is that when you assess cardiovascular risk in South Asians and Black people, you need to add about ten years to the patient-so if they’re forty just act as if they’re fifty and then calculate their risk, because their vascular system has early vascular aging. That would be a better way to look at them rather than only to look at the blood pressure or lipid levels-because you can under estimate the risk if you only look at their lipid levels.”