Coronary Artery Disease In Asian Indians: An Update And Review

Enas, Enas A; Senthilkumar, Annamalai
January 2003
Internet Journal of Cardiology;2003, Vol. 2 Issue 1, p12
Academic Journal
Coronary artery disease (CAD) rates vary 10-fold among populations. The CAD rates among overseas Asian Indians worldwide are 50% to 400% higher than people of other ethnic origin irrespective of gender, religion, or social class. India is now in the middle of a CAD epidemic with urban Indians having CAD rates similar to overseas Indians, which is 4-fold higher than Americans. Whereas the CAD rates halved in the West in the past 30 years, the rates doubled in India with no signs of a downturn yet. The average age of first myocardial infarction (MI) has decreased by 20 years in India. Among Asian Indian men, about half of all MI occur under the age of 50 and 25% under the age of 40. Apart from glucose intolerance, they have no excess of conventional risk factors such as cigarette smoking, hypertension, and high cholesterol levels. Nearly half of them are life-long vegetarians. This excess burden of premature CAD in Asian Indians is due to a genetic susceptibility, mediated through elevated levels of lipoprotein(a) {Lp(a)}, which magnifies the adverse effects of lifestyle factors associated with urbanization, affluence, and changes in diet. It appears that at a given level of any single or combination of conventional risk factor(s), the CAD rates among Asian Indians are at least double that of Whites. A more aggressive approach to prevention and treatment of both conventional and emerging risk factors is warranted in the Asian Indians. Although CAD is a fatal disease with no known cure, it is also highly predictable, preventable, and treatable with the existing knowledge.


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