Ethnic and sex inequalities in premature coronary artery disease across disaggregated South Asian and Black subgroups in England: a population-based cohort study

The study examined premature coronary artery disease (CAD) in adults aged 18-45 years in England using primary care data. Among 14.8 million adults, 16,001 premature CAD events occurred, with 77.6% in men. South Asian men had 1.87 times higher risk than Europeans, with Bangladeshi men showing the highest risk (2.79 times). Black populations had lower risk than Europeans. South Asian women showed no overall excess risk, but Pakistani women had significantly elevated risk (1.56 times). The risk was already evident in young adults aged 18-26 years. Current screening programmes starting at age 40 are too late to reach these high-risk groups.