High incidence of cardiovascular disease among Indian Asians in the UK is baffling doctors

A large community of Indian Asians – also sometimes called South Asians- reside in the UK. These are people who originated from the Indian subcontinent – from the countries of India, Pakistan, Bangladesh and Sri Lanka.

Results from a recent prospective study show that Indian Asian patients with acute coronary heart syndrome are way much younger than white Europeans. It is not uncommon to see Indian Asians in their 20s being diagnosed with severe coronary artery disease.

The prospective study was conducted at Ealing hospital in West London. From May 2005 to July 2007, 584 patients were admitted at the hospital’s chest pain clinic. 327 of the patients were of Indian Asian ethnicity and 257 were white Europeans.

Indian Asian patients were on the average younger (63 years old) than the white patients (70.7 years old). In addition, more Indian Asians have diabetes, cholesterol problems, hypertension, triple-vessel disease and coronary artery disease. In fact, there is a two-fold higher mortality due to coronary artery disease among Indian Asians compared to white Europeans.

The results of the study are perplexing heart experts in the UK because they can’t seem to identify the cause nor pinpoint the risk factors that make Indian Asians susceptible to cardiovascular disease. Definitely it is not smoking that makes them sick since the incidence of smoking is lower among Indian Asians than whites. Conventional risk factor assessment does not shed light to the riddle but genetics may be involved.

Although the majority of the study participants were male (more than 60%), the same trend was observed when the results were adjusted for gender. That means this the pattern also holds true for Indian Asian women as well when compared to white European females.

The results of the study indicate that early screening in this ethnic group is necessary.

“Currently, UK recommendations stipulate that screening should begin in the general population from the age of 40 onward… Indian Asians should be screened from the age of 30.”

Cardiovascular disease starts at an early age even though the clinical symptoms may only manifest later in life. Through early screening, prophylactic therapies and preventive strategies though lifestyle changes can be implemented so that the serious consequences of the disease can be minimized, even halted.

The study was presented by Dr Anoop Mansoor of the Imperial College during the European Society of Cardiology Congress held in Munich last Augus 30 to September 3, 2008.

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