Data_Sheet_1_Antihypertensive Medication Use and Its Effects on Blood Pressure and Haemodynamics in a Tri-ethnic Population Cohort: Southall and Brent Revisited (SABRE).docx

Objectives:We characterised differences in BP control and use of antihypertensive medications in European (EA), South Asian (SA) and African-Caribbean (AC) people with hypertension and investigated the potential role of type 2 diabetes (T2DM), reduced arterial compliance (Ca), and antihypertensive medication use in any differences.Methods:Analysis was restricted to individuals with hypertension [age range 59–85 years; N = 852 (EA = 328, SA = 356, and AC =168)]. Questionnaires, anthropometry, BP measurements, echocardiography, and fasting blood assays were performed. BP control was classified according to UK guidelines operating at the time of the study. Data were analysed using generalised structural equation models, multivariable regression and treatment effect models.Results:SA and AC people were more likely to receive treatment for high BP and received a greater average number of antihypertensive agents, but despite this a smaller proportion of SA and AC achieved control of BP to target [age and sex adjusted odds ratio (95% confidence interval) = 0.52 (0.38, 0.72) and 0.64 (0.43, 0.96), respectively]. Differences in BP control were partially attenuated by controlling for the higher prevalence of T2DM and reduced Ca in SA and AC. There was little difference in choice of antihypertensive agent by ethnicity and no evidence that differences in efficacy of antihypertensive regimens contributed to ethnic differences in BP control.Conclusions:T2DM and more adverse arterial stiffness are important factors in the poorer BP control in SA and AC people. More effort is required to achieve better control of BP, particularly in UK ethnic minorities.</p

Ethnic differences in the association between age at natural menopause and risk of type 2 diabetes mellitus among postmenopausal women: a pooled analysis of individual data from 13 cohort studies

Objective: To investigate associations between age at natural menopause, particularly premature ovarian insufficiency (POI; natural menopause before 40 years), and incident type 2 diabetes (T2DM) and identify any variations by ethnicity.Research design and methods: We pooled individual-level data of 338,059 women from 13 cohort studies without T2DM before menopause, with six ethnic groups: White (n=177,674), Chinese (n=146,008), Japanese (n=9,061), South/Southeast Asian (n=2,228), Black (n=1,838), and Mixed/Other (n=1,250). Hazard ratios (HRs) of T2DM associated with age at menopause were estimated in the overall sample and by ethnicity, with study as a random effect. For each ethnic group, we further stratified the association by birth year, education level, and BMI.Results: Over nine years of follow-up, 20,064 (5.9%) women developed T2DM. Overall, POI (vs menopause at 50-51 years) was associated with an increased risk of T2DM (HR:1.31, 1.20-1.44), while there was an interaction between age at menopause and ethnicity (pConclusions: POI and early menopause are risk factors for T2DM in postmenopausal women, with considerable variation across ethnic groups, and may need to be considered in risk assessments of T2DM among women.</p