Adjusting protocols in clinical research: finding the point of cultural/clinical fusion

The Hauora Manawa/Heart Health: Community Heart Study is a research project currently being undertaken at the University of Otago, Christchurch. The purpose of this study is to identify the prevalence of cardiovascular risk within three cohorts: a rural Maori (Wairoa, Hawkes Bay), an urban Maori (Christchurch) with an age- and gender-matched non-Maori cohort (Christchurch). Participants (aged 20–64 years) were randomly selected through the electoral roll and invited to take part in a 1.5–2-hour cardiovascular screening clinic (undertaken in Wairoa in 2007, Christchurch in 2008) then to participate in a 20-minute follow-up visit two years later to further measure and monitor any changes to their cardiovascular risk

Hyperuricaemia and gout in New Zealand rural and urban Māori and non-Māori communities

Background: There are few current data on the prevalence of hyperuricaemia and gout in New Zealand, particularly among the indigenous Māori population. Aims: To determine the prevalence of gout and hyperuricaemia in rural and urban Māori and non-Māori community samples and describe the treatment and comorbidities of participants with gout. Methods: Participants aged 20-64 years were recruited by random selection from the electoral roll. Māori samples were selected from among those identified as being of Māori descent on the roll and who self-identified as being of Māori ethnicity at interview. Personal medical history, blood pressure, anthropometrics, fasting lipids, glucose, HbA1c and urate were recorded. Results: There were 751 participants. Mean serum urate (SU) was 0.30 mmol/L (0.06-0.69 mmol/L). Māori had a significantly higher prevalence of hyperuricaemia (SU > 0.40 mmol/L) compared with non-Māori (17.0% vs 7.5%, P = 0.0003). A total of 57 participants had a history of gout, with a higher prevalence in Māori compared with non-Māori (10.3% vs 2.3%, P 0.36 mmol/L. Participants with gout were more likely to have metabolic syndrome, diabetes, cardiac disease or hypertension. Conclusions: Gout and hyperuricaemia were more prevalent in Māori, and participants with gout were more likely to have comorbidities. There was not a higher overall adjusted cardiovascular disease risk in Māori participants with gout. Despite the high prevalence of gout, management remains suboptimal. (© 2012 The Authors; Internal Medicine Journal © 2012 Royal Australasian College of Physicians.