Risk Factors for Coronary Heart Disease in a Population with a High Prevalence of Obesity and Diabetes: A Case-Control Study of the Polynesian Population of Western Samoa

Objective To evaluate anthropometric, haemodynamic and biochemical risk markers for coronary heart disease (CHD) in the Polynesian population of Western Samoa in a case-control study of 43 cases of CHD compared with 90 age- (mean 53 years) and sex-matched controls.Methods Cases were identified on the basis of a 12-lead electrocardiogram and clinical history.Results More than 60% of the participants had a body mass index ≥ 30 kg/m2 and nearly 80% had central obesity. Both diabetes mellitus (17%) and impaired glucose tolerance (9%) were also common in this population. Nineteen per cent of the population were hypertensive and both antihypertensive therapy (21 versus 1%, P<0.001, risk 23.6) and hypertension (35 versus 11%, P<0.01, risk 4.3) were significantly more common among cases than they were among controls. In addition, the plasma high-density lipoprotein cholesterol level was lower (1.00±0.09 versus 1.24±0.05 mmol/l, P<0.05) and the plasma urate level was higher (0.42±0.02 versus 0.37±0.01 mmol/l, P<0....