Breaking barriers to heal hearts: differences in baseline characteristics between white and south asian populations who started core cardiac rehabilitation

Background

South Asian individuals are at higher of risk heart disease compared to White British, however are under-represented in cardiac rehabilitation (CR) despite its proven benefits. Reduced attendance and completion rates of CR are seen in eligible South Asian populations, increasing risk of recurrent cardiac events. Comparing South Asian (Indian, Pakistani, Bangladeshi, Other Asian) and White (British, Irish, Other White) populations will provide an overview of socio-demographics, to better inform strategic approaches to increasing uptake and completion.

Aim

Compare characteristics of South Asian and White populations who started core CR in UK.

Methods

Statistical analysis (via StataBE v17) on National Audit of Cardiac Rehabilitation (NACR) data was performed to compare characteristics of South Asian and White populations who started core CR between Jan 2014 – Jan 2023. Chi-squared tests for categorical data, and Wilcoxon rank-sum for continuous variables were used to check if observed frequencies matched expected outcomes. Initiating events were: myocardial infarction (MI), percutaneous coronary intervention (PCI/PPCI) and coronary artery bypass (CABG).

Results

Sample size n= 269,258 (White population: female, 25.7%, median age 66 years, South Asian population: female 19.9% and 60 years, table 1). Results revealed statistically significant (p<0.001) differences in: age, sex, index of multiple deprivation, marital status, employment status and number of co-morbidities. South Asian population were more likely to start CR than White population (55.5% and 54.7% respectively p<0.001) however are less likely to complete CR (71% and 77% respectively, p<0.001).

Conclusion

NACR data identifies significant differences between populations in multiple socio-demographics including; age, sex, index of multiple deprivation, marital and employment status, and total number of co-morbidities. When socio-demographics combine, health inequalities faced by South Asian ethnicities increase. The characteristics of each population can be used by key stakeholders to develop targeted, culturally appropriate, interventions to improve CR utilisation, and build innovation for the future.