Shahwan-Akl, Lina (2001) Prevalence of Cardiovascular Risk Factors Among Australian-Lebanese in Melbourne. PhD thesis, Victoria University.

Abstract

In modern industrialized countries coronary heart disease is the single most important cause of death and disability as well as the biggest cause of premature death. There are known global geographical variations in the incidence of coronary heart disease with currently the Eastern European countries having the highest mortality rates, Australia in the middle of the range and Spain, France and Japan having the lowest. Coronary heart disease still remains to be a leading cause of death in Australia, despite its decline in the past 25 years, which is mainly attributed to the improvements in medical management and to the lower prevalence of behaviours which increase the risk of heart disease. Australia is a multicultural society and a country where one person in five is born overseas thus, its national health profile is significantly determined by the health of its immigrants. It is evident from the literature that the mortality rate from CHD amongst immigrant groups in Australia is lower than that of the Australian-born. This is explained by the stringent selection processes involved in migration approvals where only healthy strong immigrants are selected to come to Australia. However, there is increasing incidence of coronary heart disease amongst migrant Australians. Some of the identified factors that may be influencing this increase are mainly those associated with the stress of migration and settlement, loss of status and socioeconomic disadvantage, limited access to health information as well as changes of life style which occur with increased acculturation as the duration of residence in Australia increases. This study was designed to examine the cardiovascular health profile, health knowledge, attitudes, beliefs, and health behaviours, perceptions and barriers to behavioural change of an adult sample of a non-English speaking background community in Melbourne namely, the Australian-Lebanese. The health practices of this migrant group had never been studied and to date there is a paucity of literature regarding their health needs. This study provided information on the demographic and physical characteristics, life style factors, health and associated behaviours in relation to cardiovascular risk factors. The summary of findings below highlights a number of points of interest, and where possible comparisons were made with national figures derived from the 1989 National Heart Foundation Risk Factor Prevalence Study (NHF, 1990). The main findings were: Blood pressure and hypertension: The proportion of men and women who were hypertensive in this study increased steadily with age. 12.5% men and 7% of the women were found to have a diastolic blood pressure above 95mmHg. This is higher than the national figures of the 1989 NHFRFPS that were 11% of Australian men and 5% of Australian women had a diastolic blood pressure above 95 mmHg. High blood cholesterol: The proportion of men and women who had high blood cholesterol levels increased steadily with age. 8% of the men and 10% of the women reported having blood cholesterol levels greater than 6.5mmol/L. This is lower than the 1989 national figures where 16% of the men and 14% of the women had cholesterol levels greater than 6.5mmol/L (NHF, 1990). Smoking behaviour: 44% of the Australian-Lebanese men and 25% of Australia- Lebanese women in this study were smokers compared with 24% of men and 21% of women of the 1989 NHFRFPS (NHF, 1990). All the Australian-Lebanese women smokers were in the middle and younger age groups (less than 44 years). Exercise for recreation sport or health fitness: Lack of exercise for recreation was prevalent among the Australian-Lebanese, about 55% of the men and 47% of the women had no exercise of any kind during leisure time in the preceding fortnight, as compared with 27% of Australian men and women according to the national figures (NHF, 1990). Overweight and obesity: Overweight and obesity were prevalent among the Australian-Lebanese. 71% of the men and 67% of the women were found to be either overweight or obese. This ratio is much higher than the national figures (NHF, 1990) with 60% of the men and 50% of the women being overweight or obese. The prevalence of overweight and obesity in this study increased with age for both sexes. 48% of the total Australian-Lebanese sample were overweight and 24% were obese. 41% of men and 38% of women were overweight and 21% of men and 37% of women were obese. Alcohol intake: Drinking alcohol was not a major risk factor among the Australian- Lebanese sample since most were occasional drinkers. 43% of men and 77% of women said they never drank any alcoholic beverages. This is quite a low ratio compared with the national figures where 87% of the men and 75% of the women drank alcohol. Dietary behaviour: 96% of men and 90% of women did not follow any kind of special diet. A fat-modified diet to lower blood fat was followed by one man and 3 women. One man and one woman reported following a diabetic diet. Five women followed a weight-reduction diet. 61% of men and 68% of women rarely ate fat on meat. 80% of men and 86% of women rarely added salt to cooked food compared to 49% of Australian men and 58% of Australian women who rarely or never added salt to their food (NHF, 1990). Major risk factors: A multiple forward logistic regression was conducted to assess which demographic factors predicted having a major risk factor or not. The strongest predictor was gender, with males more likely to have a major risk factor. The second strongest predictor was age with those in the older age group (45-69 years) being more likely to have a major risk factor and the next strongest predictor was education with those who have no formal education or primary school education only, being more likely to have a major risk factor. These cross-sectional observations provide the basis for interventional-type studies and should lead to appropriate recommendations regarding health promotion and education programs that can contribute to reducing the risks of cardiovascular disease in this non-English speaking background community.

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