Vascular disease in West Indian and white diabetics in Britain and Jamaica

Summary Cardiovascular complication rates among matched groups of black and white diabetics in England were compared with those among black diabetics in Kingston, Jamaica. Raised or uncontrolled blood pressure (≥ 160/95 mmHg) was common in all groups but diastolic hypertension was more severe in black patients. Despite this, clinical evidence of myocardial ischaemia was significantly more common in whites when compared with blacks in both centres but no such differences were found in peripheral vascular disease. Cataracts were much more frequent, and background retinopathy was slightly although not significantly commoner, in black patients. Complication rates were not correlated with cigarette smoking which was greatest in black men in Birmingham. The diagnosis and continuous control of hypertension remains a major goal in diabetes.