Abstract
Prevalence and mortality from cardiovascular disease (CVD) is rising among South Asians while declining throughout the western world. The increasing prevalence of CVD risk factors in South Asians, particularly obesity and diabetes, is a major cause. Studies suggest the genetic predispositions as well as environmental and lifestyle factors are equally important contributors to disease development. It is important that healthcare providers become increasingly familiar with the risk factors in South Asians and recognize the specific differences that exist compared to other populations. Scientific effort should in particular focus on identifying the underlying genetic causes and novel biomarkers for CVD. Such effort should help with development of novel therapeutics and disease control and prevention.
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Paper of particular interest, published recently, have been highlighted as: •• Of major importance
Organization WH. The world health report 2005. Preventing chronic disease: a vital investment. Geneva: WHO; 2005.
U.S. Census Bureau 2010; www.Census.gov.
Yusuf, et al. Effect of potentially modifiable risk factors associated with myocardial infarction in 52 countries (the INTERHEART Study): case control. Lancet. 2004;364:932–52.
Sheth T, et al. Cardiovascular and cancer mortality among Canadians of European, South-Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 Million deaths. CMAJ. 1999;161:132–8.
Gupta M. Risk Factors, hospital management and outcomes after acute myocardial infarction in South Asian Canadians and matched control subjects. Can Med J. 2002;166:717–22.
Gupta M. Canadian South Asians have more severe angiography coronary disease.
•• Misra et al. Obesity-related non-communiciable diseases: South Asians vs White Caucasians. International Journal of Obesity. 2011;35:167–187. With over 300 references, this article provides a thorough review of mechanisms and management of obesity-related non-communicable diseases.
Dudeja V, et al. BMI does not accurately predict overweight in Asian Indians in northern India. Br J Nutr. 2001;86:105–12.
Lear SA et al. Visceral adipose tissue accumulation differs according to ethnic background; results of the Multicultural Community Health Assessment Trial (M-CHAT). American Journal of Clinical Nutrition.
Misra, et al. Consensus statement for diagnosis of obesity, abdominal obesity and metabolic syndrome for Asian Indians and recommendations for physical activity, medical and surgical management. J Assoc Phys India. 2009;57:163–70.
Gupta R, et al. Younger age of escalation of cardiovascular risk factor in Asian Indian subjects. BMC Cardiovasc Disord. 2009;9:28.
Sniderman AD, et al. Why might South Asians be so susceptible to central obesity and artherogenic consequences? The adipose tissue overflow hypothesis. Int J Epidemiol. 2007;36:220–5.
Eapen D, et al. Metabolic syndrome and cardiovascular disease in South Asians. Vascular Health Risk Manag. 2009;5:731–43.
Misra, Khurana. The metabolic syndrome in South Asians: epidemiology, determinants and prevention. Metab Syndr Relat Disord. 2009;7:497–514.
Reddy KS, et al. Prevalence of metabolic syndrome in an Indian urban population. Int J Cardiol. 2004;97:257–61.
Whincup PH, et al. Early evidence of ethnic differences in cardiovascular risk: cross sectional comparison of British South Asian and white children. BMJ. 2002;324:635.
Vikram NK, et al. Heterogeneous phenotypes of insulin resistance and its implications for defining metabolic syndrome in Asian Indian adolescents. Atherosclerosis. 2005;186:193–9.
Aijan R, et al. Ethnic differences in cardiovascular risk factors in healthy Caucasians and South Asian individuals with metabolic syndrome. J Thomb Haemost. 2007;5:754–60.
Bainey KR, et al. Increased burden of coronary artery disease in South Asians living in North America. Need for aggressive management algorithm. J Atheroscler. 2009;204:1–10.
Misra A, Vikram NK. Insulin resistance syndrome ( metabolic syndrome) and obesity in Asian Indians: evidence and implications. Nutrition. 2004;20(5):482–91.
McKeigure PM, et al. Relation of central obesity and insulin resistance with high diabetes prevalence and cardiovascular risk in South Asians. Lancet. 1991;337(8738):382–6.
Raji A, et al. Insulin resistance and vascular dysfunction in nondiabetic Asian Indians. J Clin Endocrinol Metab. 2004;89(8):3965–72.
Luthra A, et al. Metabolic correlates of non-alcoholic fatty liver disease and management issues: a perspective for Asian Indians. Diabet MetabSyndr: Res Revs. 2007;1:279–85.
Peterson KF, et al. Increased prevalence of insulin resistance and nonalcoholic fatty liver disease in Asian Indian men. ProcNatlAcadSci USA. 2006;103:18273–7.
Kulkarni KR, et al. Increased prevalence of smaller and denser LDL particles in Asian Indians. Arterosler Thromb VascBiol. 1999;19:2749–55.
Lorenzo C et al. The national cholesterol education program-adult treatment panel III, international diabetes federation and world health organization definitions of the metabolic syndrome as predictors of incident cardiovascular disease and diabetes. Diabetes Care. 2007;30:8–13.
Sattar, et al. Can metabolic syndrome usefully predicts cardiovascular disease and diabetes? Outcome data from two prospective studies. Lancet. 2008;371:1927–35.
Ramaraj, et al. Cardiovascular risk in South Asians. Postgrad Med J. 2008;84:518–23.
Mathur HM. Mortality and morbidity from South Asians and Europeans: 11- year follow-up of the Southall diabetes survey, London UK. Diabet Med. 1998;15:53–9.
Raymond NT, et al. Higher prevalence of retinopathy in diabetic patients of South Asian ethnicity compared with white Europeans in the community: a cross-sectional study. Diabetes Care. 2009;32:410–5.
Venkataraman R, et al. Prevalence of diabetes mellitus and related conditions in Asian Indians living in the United States. Am J Cardiol. 2004;94:977–80.
Joshi P, et al. Risk factors for early myocardial infarction in south Asians compared with individuals in orther countries. JAMA. 2007;297:286–94.
Rani M, et al. Tobacco use in India: prevalence and predictors of smoking and chewing in a national cross sectional household survey. Tob Control. 2003;12:4. Article e4.
Delnevo et al. “Epidemiology of cigarette and smokeless tobacco use among South Asian immigrants in the Northeastern United States”. J Oncol. 2011.
Bhopal R, et al. Heterogeneity of coronary heart disease risk factos in Indian, Pakistani, Bangledeshi and European origin populations: cross sectional study. BMJ. 1999;319:215–20.
Almas, et al. Adiposity and blood pressure in south Asian children and adolescents in Karachi. Am J Hypertens. 2011;24:876–80.
Gunarthne, et al. Impact of mean arterial blood pressure on higher arterial stiffness indices in South Asians compared to white Europeans. J Hypertens. 2008;26:1420–6.
Abate N, et al. Genetic polymorphism PC-1K121Qand ethnic susceptibility to insulin resistance. J Clin Endocrinol Metab. 2003;88:5927–34.
•• Watkins H. (Chair) et al. “A Genome-wide association study in Europeans and South Asians identifies five new loci for coronary artery disease” Nat Genet. 2011. 43; 339–343. This is an excellent study of identified common variants associated with cardiovascular disease in South Asians.
Tabassum, et al. Evaluation of DOK5 as a susceptibility gene for type 2 diabetes and obesity in North Indian population. BMC Med Genet. 2010;11:35.
Misra A, et al. Migration and its impact on adiposity and type II diabetes. Nutrition. 2007;23:696–708.
Hayes, et al. Patterns of physical activity and relationship with risk markers for cardiovascular disease and diabetes in Indian, Pakistani, Bangladeshi and European adults in a UK population. J Public Health Med. 2002;24:170–8.
Yajnik CS, et al. Obesity epidemic in India: intrauterine origins? Proc Nutr Soc. 2004;63:387–96.
Misra A, et al. South Asian diets and insulin resistance. Br J Nutr. 2009;10:465–73.
Lip GY, et al. Dietary fat purchasing habits in whites, blacks and Asian peoples in England—implications for heart disease prevention. Int J Cardiol. 1995;48:287–93.
•• Enas E et al. Recommendations of the Second Indo-US Health Summit on Prevention and Control of Cardiovascular Disease among Asian Indians. Indian Heart J. 2009;61(3):265–74. These are recent expert consensus guidelines regarding clinical management and risk stratification of South Asians.
Dixon A, et al (2006) “Prevalence of microalbuminuria and hypertension in South Asians and Europeans with diabetes: a report from the United Kingdom Asian Diabetes Study (UKADS)”. Diabet Vascular Dis Res.
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Khanna, P., Mani, A. Prevalence of Obesity and Traditional Cardiovascular Risk Factors in South Asians. Curr Cardiovasc Risk Rep 6, 112–119 (2012). https://doi.org/10.1007/s12170-012-0220-x
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DOI: https://doi.org/10.1007/s12170-012-0220-x