Thursday, February 22, 2007

South Asians and CAD

Ever since I was in Medical school, my old boss (Prof Danaraj) has always taught us that Indians (south Asians), had a higher incidence of heart disease, and that their AMIs tend to occur at a younger age group. I have seen AMIs in Indians as young as 29 years old. I think some of my colleagues have seen younger. Not so long ago, an eminent psychiatrist in this country had postulated that Indians may suffer from the "hurry, curry, bury syndrome", meaning that stress and running around eating banana leave curry rice may be partly responsible for the increase incidence of CAD that we see in Indians.

There was then little medical evidence to support. Well, in the January 17th issue of the Journal of the American Medical Association, Dr Joshi of the Government Medical College of Naipur India reported their study of 1732 patients with first AMIs and 2204 controls in South Asians, and compared them with 10,728 patients with first AMIs and 12,431 controls from elsewhere in the world (they did not specify where). Well, Dr Joshi and researchers concluded that South Asians have their first AMI almost 5-10 years younger then their peers from other countries. They also found that their risk factors were the same as those from other countries except that they seem to accumulate those risk factors from earlier in life.

We do not have to postulate any added genetic factors. Just the same coronary risk factors as in Caucasians except that they seem to acquire them earlier. There was also a higher incidence of diabetes an abdominal adiposity. Cardio-protective factors like exercise, fruits and vegetable mainly diet also seemed less prevalent in the south Asian population. Basically, Indians have their AMIs earlier in life (by almost 5-10 years), because they exercise less, eat less veges and fruits and also have higher incidence of diabetes and abdominal adiposity. There seem no increase genetic propensity, at least not from Dr Joshi's study. Well at least Dr Joshi and colleagues have shown us how to help our Indian friends how to avoid their first AMI. Just eat more vege and fruits, exercise more, avoid diabetes and truncal obesity and not worry so much about bad luck and fate.

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