People of South Asian descent, listen up. We have a big problem on our hands and there just aren't enough people who know about it.
If we don't act on this knowledge now, South Asians will continue to die of heart disease at an astronomical rate even though it's (at least partially) reversible!
Do me a favor and share this article with your South Asian friends and family (Indian, Pakistani, Bangladeshi, Nepali, or Sri Lankan descent) -- it seriously could save them from an early heart attack or even death.
The good: On one hand, South Asians (SAs) tend to have a lower weight and body mass index (BMI) then other ethnic groups.
But this is really misleading because at the same BMI, SAs have double the risk of Type 2 diabetes than whites and an increased risk for heart disease and death.
The bad: South Asians have really poor health outcomes, especially when it comes to heart disease and diabetes. SAs have four times the rates of heart disease and diabetes. They also have a much greater chance of having a heart attack before age 50.
The ugly: Lastly, almost a third of the South Asian population dies from heart disease before age 65.
Pretty alarming right?
One study found that South Asians developed heart disease 10 years earlier than other ethnic groups.
To summarize it for you, South Asians develop coronary artery disease (heart vessel disease) at a younger age, die from coronary artery diseases at younger ages, and have higher of death from coronary artery disease.
What we you do to prevent this?
Of course, traditional South Asian diets (refined carbohydrate and bad fat heavy) , and often lack of exercise, are partially to blame.
Additionally, many physicians don't realize early risk factors since the patients may look "thin" and traditional testing may look normal.
So, is there anything we can test for to uncover this increased risk?
I, as a physician, was initially surprised when I found that there are certain blood tests that are not checked regularly by doctors that could help determine your risk.
According to the Interheart study report released in 2004 involving 52 countries and 30,000 individuals, the single most important predictor of Myocardial Infarction (heart attack) is the ratio of two proteins in the blood -- Apolipoprotein B ( ApoB in short ) & Apolipoprotein A-1 (ApoA-1).
This ratio ( ApoB / ApoA-1) is a strong risk predictor of heart disease -- better than the standard lipid panel etc.
The reason I am telling you this is that these Apolipoproteins are not checked in the standard lipid profile test and therefore the standard lipid profile test is missing this key helpful marker.
Specifically for certain ethnic groups -- this test is a better predictor then a cholesterol or lipid panel.
What is this test?
Apolipoprotein A-1 is the major protein of HDL particle -- which is large and fluffy. It is responsible for reverse cholesterol transport in the blood -- taking the cholesterol back to the liver from the cells.
Apolipoprotein B are small dense cholesterol carriers which get easily oxidized causing inflammation in the artery and therefore , they are atherogenic particles.
You would want more of the apo A-1 and less of the apo B.
This is an easy blood test that is available at most U.S. labs.
Of course, there are so many things we should be doing to modify the risk of death in South Asians (and all ethnic backgrounds) like increasing consumption of vegetables, increasing daily exercise, decreasing sugar, decreasing simple carbohydrates, and optimizing weight (new BMI goal
However, if you or someone you know is South Asian -- please consider these increased risk factors and this important blood test.
It could really save their life.
References:
1. Sheth T, Nair C, Nargundkar M, Anand S, Yusuf S. Cardiovascular and cancer mortality among Canadians of European, South Asian and Chinese origin from 1979 to 1993: an analysis of 1.2 million deaths. Can Med Assoc J. 1999; 161: 132-138
2. Enas EA, Garg A, Davidson MA, Nair VM, Huet BA, Yusuf S. Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America. Indian Heart J. 1996; 48: 343-353
3. Gupta M, Doobay AV, Singh N, Anand SS, Raja F, Mawji F, Kho J, Karavetian A, Yi Q, Yusuf S. Risk factors, hospital management and outcomes after acute myocardial infarction in South Asian Canadians and matched control subjects. Can Med Assoc J. 2002; 166: 717-722
4. Gupta M, Singh N, Warsi M, Reiter M, Ali K. Canadian South Asians have more severe angiographic coronary disease than European Canadians despite having fewer risk factors. Can J Cardiol. 2001; 17 (suppl C): 226C.
5. http://circ.ahajournals.org/content/113/25/e924.full
6. http://www.atherosclerosis-journal.com/article/0021-9150(91)90174-2/abstract?cc=y