Skip to main content

Roma coronary heart disease patients have more medical risk factors and greater severity of coronary heart disease than non-Roma



Coronary heart disease (CHD) is the most common cause of mortality and morbidity world-wide. Evidence on ethnic differences between the Roma and non-Roma regarding medical risk factors is scarce. The aim of this study was to assess differences in medical risk factors and the severity of CHD in Roma compared with non-Roma CHD patients, adjusted for gender, age and education.


Six hundred seventy four patients were included in this cross-sectional study (132 Roma, 542 non-Roma). Data on medical risk factors, symptoms, medication and severity of CHD were obtained from medical records. After matching Roma and non-Roma according to education, linear and logistic regression analyses with adjustments for gender and age were used.


Compared with non-Roma, Roma patients had significantly more risk factors and more severe types of CHD. They were treated less frequently with statins and beta-blockers, were more frequently left on pharmacotherapy and surgically revascularised. These differences remained after controlling for education, gender and age.


Roma CHD patients have a worse risk profile at entry of care and seem to be undertreated compared with non-Roma CHD patients.

This is a preview of subscription content, access via your institution.


  1. Allender S, Scarborough P, Peto V, Rayner M, Leal J, Luengo-Fernandez R, Gray A (2012) European Cardiovascular Disease Statistics 2008 edition, European Heart Network. Available: Accessed 5 June, 2012

  2. Bahonar A, Sarrafzadegan N, Kelishadi R, Shirani S, Ramezani MA, Taghdisi MH, Gharipour M (2011) Association of socioeconomic profiles with cardiovascular risk factors in Iran: the Isfahan Healthy Heart Program. Int J Pub Health 56:37–44

    Article  Google Scholar 

  3. Baker D, Mead N, Campbell S (2002) Inequalities in morbidity and consulting behaviour for socially vulnerable groups. Br J Gen Pract 52:124–130

    PubMed  Google Scholar 

  4. Bonaccio M, Di Castelnuovo A, Costanzo S, De Lucia F, Olivieri M, Donati MD, De Gaetano G, Iacoviello L, Bonanni A (2012) Mass media information and adherence to Mediterranean diet: results from the Moli-sani study. Int J Pub Health 57:589–597

    Article  Google Scholar 

  5. Brazdova Z, Fiala J, Hrstkova H (1998) Dietary habits of Romany children. Cs Pediatrie 53:419–423

    Google Scholar 

  6. Britton A, Shipley M, Marmot M, Hemingway H (2004) Does access to cardiac investigation and treatment contribute to social and ethnic differences in coronary heart disease? Whitehall II prospective cohort study. BMJ Clin Res Ed 329:318

    Article  Google Scholar 

  7. Cappuccio FP (1997) Ethnicity and cardiovascular risk: variations in people of African ancestry and South Asian origin. J Hum Hypertens 11:571–576

    PubMed  Article  CAS  Google Scholar 

  8. Cappuccio FP, Cook DG, Atkinson RW, Strazzullo P (1997) Prevalence, detection, and management of cardiovascular risk factors in different ethnic groups in south London. Heart Br Cardiac Soc) 78:555–563

    CAS  Google Scholar 

  9. Cappuccio FP, Oakeshott P, Strazzullo P, Kerry SM (2002) Application of Framingham risk estimates to ethnic minorities in United Kingdom and implications for primary prevention of heart disease in general practice: cross sectional population based study. BMJ Clin Res Ed 325:1271

    Article  Google Scholar 

  10. Cirera L, Huerta JM, Chirlaque MD, Buckland G, Larranaga N, Sanchez MJ, Agudo A, Amiano P, Quiros JR, Ardanaz E, Arriola L, Molina E, Dorronsoro M, Barricarte A, Gonzalez CA (2013) Moreno-Iribas C and Carmen Navarro. Int J Pub Health 58:65–77

    Article  Google Scholar 

  11. D’Agostino RBS, Vasan RS, Pencina MJ, Wolf PA, Cobain M, Massaro JM, Kannel WB (2008) General cardiovascular risk profile for use in primary care: the Framingham heart study. Circulation 117:743–753

    PubMed  Article  Google Scholar 

  12. Filadelfiova J, Gerbery D, Skobla D (2007) Report on the living conditions of Roma in Slovakia. UNDP Regional Bureau for Europe and the Commonwealth of Independent States, Bratislava

    Google Scholar 

  13. Foets M (2011) Improving the quality of research into the health of migrant and ethnic groups. Int J Pub Health 56:455–456

    Article  Google Scholar 

  14. Foldes ME, Covaci A (2012) Research on Roma health and access to healthcare: state of the art and future challenges. Int J Pub Health 57:37–39

    Article  Google Scholar 

  15. Ginter E (1998) The health of Gypsies. Governments and Roma communities must help to improve outlook for Gypsies. BMJ Clin Res Ed 316:1825

    CAS  Google Scholar 

  16. Ginter E, Krajcovicova-Kudlackova M, Kacala O, Kovacic V, Valachovicova M (2001) Health status of Romanies (Gypsies) in the Slovak Republic and in the neighbouring countries. Bratisl Lek Listy 102:479–484

    PubMed  CAS  Google Scholar 

  17. Graham I, Atar D, Borch-Johnsen K, Boysen G, Burell G, Cifkova R, Dallongeville J, De Backer G, Ebrahim S, Gjelsvik B, Herrmann-Lingen C, Hoes A, Humphries S, Knapton M, Perk J, Priori SG, Pyorala K, Reiner Z, Ruilope L, Sans-Menendez S, Scholte OP, Reimer W, Weissberg P, Wood D, Yarnell J, Zamorano JL, Walma E, Fitzgerald T, Cooney MT, Dudina A, European Society of Cardiology (ESC), Committee for Practice Guidelines (CPG) (2007) European guidelines on cardiovascular disease prevention in clinical practice: executive summary: Fourth joint task force of the European society of cardiology and other societies on cardiovascular disease prevention in clinical practice (constituted by representatives of nine societies and by invited experts). Europ Heart J 28:2375–2414

    Article  Google Scholar 

  18. Hajioff S, Mckee M (2000) The health of the Roma people: a review of the published literature. J Epidemiol Commun Health 54:864–869

    Article  CAS  Google Scholar 

  19. Hajsheikholeslami F, Hatami M, Hadaegh F, Ghanbarian A, Azizi F (2011) Association of educational status with cardiovascular disease: Teheran lipid and glucose study. Int J Pub Health 56:281–287

    Article  Google Scholar 

  20. Kolvek G, Rosicova K, Rosenberger J, Podracka L, Stewart RE, Nagyova I, Reijneveld SA, van Dijk JP (2012) End-stage renal disease among Roma and non-Roma: Roma are at risk. Int J Pub Health 57:751–754

    Article  Google Scholar 

  21. Koupilova I, Epstein H, Holcik J, Hajioff S, Mckee M (2001) Health needs of the Roma population in the Czech and Slovak Republics. Soc Sci Med 53:1191–1204

    PubMed  Article  CAS  Google Scholar 

  22. Mckee M (1997) The health of gypsies. BMJ Clin Res Ed 315:1172–1173

    Article  CAS  Google Scholar 

  23. Nozdrovicky P (1991) Mortality from cardiovascular diseases in Gypsy. Slov Lekar 15:13–14

    Google Scholar 

  24. Reijneveld SA (2010) Ethnic differences in health and use of health care: the questions to be answered. Int J Pub Health 55:353–355

    Article  Google Scholar 

  25. Rosicova K, Madarasova Geckova A, van Dijk JP, Kollarova J, Rosic M, Groothoff JW (2011) Regional socioeconomic indicators and ethnicity as predictors of regional infant mortality rate in Slovakia. Int J Pub Health 56:523–531

    Article  Google Scholar 

  26. Vano B (2001) Demographic characteristics of the Roma population in the SR. INFOSTAT, Demographic Research Center, Bratislava

    Google Scholar 

  27. Vozarova De Courten B, De Courten M, Hanson RL, Zahorakova A, Egyenes HP, Tataranni PA, Bennett PH, Vozar J (2003) Higher prevalence of type 2 diabetes, metabolic syndrome and cardiovascular diseases in gypsies than in non-gypsies in Slovakia. Diabetes Res Clin Pract 62:95–103

    PubMed  Article  Google Scholar 

Download references


This work was supported by a grant from the Slovak Society of Cardiology, year 2005. This work was supported by the Slovak Research and Development Agency under contract No. APVV- 20-038305 (20 %) and APVV-0220-10 (60 %). Furthermore, this work was partially supported by the Agency of the Slovak Ministry of the Education, Science, Research and Sport of the Slovak Republic for the Structural Funds of the EU under project No. ITMS: 26220120058 (20 %).

Author information



Corresponding author

Correspondence to A. Sudzinova.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Sudzinova, A., Nagyova, I., Studencan, M. et al. Roma coronary heart disease patients have more medical risk factors and greater severity of coronary heart disease than non-Roma. Int J Public Health 58, 409–415 (2013).

Download citation


  • Roma
  • Coronary heart disease
  • Medical risk factors
  • Coronary angiography