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Sounds pretty alarming statement isn’t it!! But it is TRUE.
Many of you might have noticed or realized the fact that there seems to be sudden increase in heart attacks/strokes in India. As a physician, I wanted to bring this topic to you so that you can share it to your family members and take necessary precautions and provide them awareness and its future implications.
Researchers have determined that those of Indian and Pakistani descent have the highest rates of heart disease in the world, despite coming from a culture that shuns smoking, encourages a vegetarian diet and lacks many of the other classic risk factors for the disease.
About 25 percent of all heart attacks among men of Indian (Asian) descent occur while they are younger than 40, unheard of in any other population, according to Cardiologists. Death rates from the disease are up to three times higher among Indians than those of European or East-Asian origin. Such findings, borne out most recently by a new report, surprise many Indo-Americans - and just as many doctors. Research carried out in the United Kingdom years ago began to suggest a genetic link, but there has not been a push for early screening in the Indo-American community here, and relatively few education campaigns. And this lack of awareness, researchers worry, may be deadly. "Just being of Asian-Indian descent places you at higher risk for heart disease than having high cholesterol and being a smoker.
The National Asian Indian Heart Disease Program, several years ago and discovered one gene is responsible for part of the increased risk in heart disease rates. A metabolic disorder common in Indians likely also plays a role, as does having high levels of a dangerous type of cholesterol. Lifestyle, such as diet and lack of exercise, is also to blame.
But there are 1.6 million Indians sprinkled all over the United States who are also at risk. Because the population is scattered, researchers say it is difficult to study the problem fully or raise awareness among doctors and within communities. The elevated risk of heart disease often catches many Indians off guard. Generally, their overall cholesterol levels have been normal. High blood pressure isn’t prevalent in the community. Smoking rates are low. And about half are vegetarians.
As all of you know, lifestyles changing rapidly in India, heart disease is hitting epidemic proportions there - and also among Indo-Americans - with more than 10 percent of urban Indians now suffering from the disease. Over the past three decades, coronary artery disease rates have declined by half in many developed countries, but have more than doubled in India, according to the Coronary Artery Disease among Asian Indians Research Foundation. Heart attack rates are significantly higher in urban regions of India than in rural ones. "Genetics load the gun. Environment pulls the trigger," said Dr. Enas, director of the research foundation. "If you have a loaded gun and you don’t pull the trigger, no harm is done."
Cardiologists believe that the children and grandchildren of Indian immigrants could be at the highest risk for heart problems, given their lifestyle as children is much more inactive than their parents’ tended be. As a group, Asian Indians have one of the highest rates of heart disease in the world, three times higher than in the United States. In spite of a fairly healthy lifestyle, many Asian Indians have very high levels of the blood fat triglyceride and low levels of HDL (the good cholesterol), as well as a high incidence of diabetes. Researchers have been trying to figure out why the group is at higher risk.
Now, a University of Maryland Medical Center study provides evidence that a genetic abnormality could explain the difference. The study results were presented on November 8 at the 72nd Annual Scientific Sessions of the American Heart Association in Atlanta, Georgia.
"We found that a genetic abnormality in triglyceride regulation appears to be common among Asian Indians," and "We think this abnormality prevents blood fats from being broken down effectively and, as a result, triglyceride levels may accumulate to dangerously high levels," says Michael Miller, M.D., director, Center for Preventive Cardiology at the University of Maryland Medical Center and principle investigator of the study.
For the study, Dr. Miller analyzed blood samples and DNA from 100 people of Asian Indian decent who had gathered at an Indian festival in Northern Virginia and volunteered to have their blood drawn. The vast majority of the people tested, 70 percent, had the same genetic abnormality in triglyceride regulation, placing them at increased risk of heart disease.
Triglyceride is a type of fat that is always circulating in the blood, especially after a meal high in saturated fat. Usually, triglyceride particles are broken down by enzymes. When that process is not working efficiently, the triglycerides that are only partially broken down can cause fatty deposits in blood vessels, leading to atherosclerosis, known as hardening of the arteries.
Triglycerides have also been shown to increase the risk of blood clots, which combine with fatty deposits in the coronary vessels to cause heart attacks. Previous work by Dr. Miller and his research team demonstrated that triglyceride levels above 100 mg/dL increase the risk of heart disease. The average triglyceride level among the Asian Indians in this study who had the genetic abnormality was approximately 350 mg/dL. In addition, 33 percent had a family history of heart disease and 20 percent had diabetes.
Studies have shown that the genetic abnormality found to be prevalent in this Asian Indian population is also involved with insulin regulation. That might explain the high rates of diabetes observed in this population.
The death rates from Coronary Artery Disease among overseas Asian Indians have been 50% to 300% higher than Americans, Europeans, Chinese, and Japanese, irrespective of gender, religion, or social class.
About 50% of all heart attacks among Asian Indian men occur under the age of 55 and 25% under the age of 40, unheard of in any other population.
Asian Indian women have a higher death rate from CAD than women of all other ethnic origins in the U.K., South Africa, Canada, Singapore, Fiji, Mauritius, Uganda, and Trinidad.
By 2010, 60 per cent of the world’s cardiac patients will be Indian.
Read one chapter (Heart Disease among Indians living abroad) of the book by Dr. Enas - How to beat heart disease epidemic among South Asians. Interesting that he calls this a epidemic of enormous proportion!
Here are some interesting statistics for us to note:
Coronary Artery Disease (CAD) is a Global Epidemic among South Asians |
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CAD strikes South Asians at a four-fold rate compared to the general population. This holds true even for lifelong vegetarians who do not smoke and are not overweight. |
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10-12% of the South Asian population in urban areas globally and 4% in rural areas are afflicted with this disease. |
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By 2010, India will bear 60% of the worlds CAD burden. |
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CAD strikes South Asians at a Younger Age, almost 33% earlier |
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South Asians in the United States and in urban India suffer heart attacks at an earlier age, often without prior symptoms or warning. |
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A study among Asian Indian men showed that half of all heart attacks in this population occur under the age of 50 years, and 25% under the age of 40. |
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CAD strikes South Asians Fatally |
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More than 30% of deaths from heart attacks in South Asians occur in those younger than 65 years of age, a rate double that of the U.S. national average. |
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British Heart Foundation statistics show that the death rate from coronary heart disease is 46% higher in South Asian men and 51% higher in South Asian women than the UK population as a whole. |
By Dr Morarji Peesay
President
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