South Asians in the U.S. Are at High Risk for Heart Disease

July 13, 2018

New reports claim that South Asians living in the United States have a high risk for cardiac disease.

After a comprehensive review of existing studies, researchers found that South Asians are more prone to develop early diabetes and have high cholesterol, which consequently increases the risk for plaque buildup in the arteries (atherosclerosis).

“We don’t have an answer to why South Asians have a higher risk of diabetes, but there are many genetic theories that have not been substantiated,” lead report author Annabelle Santos Volgman told NBC News.

The report, titled “Atherosclerotic Cardiovascular Disease in South Asians in the United States: Epidemiology, Risk Factors, and Treatments,” was published in the journal Circulation of the American Heart Association.

South Asians in the U.S. come from different countries, including Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan, and Sri Lanka.

In addition to having a high risk for heart disease, the report noted that South Asians are more likely to die from it than non-Hispanic Whites and other Asian American subgroups. Higher insulin resistance, hypertension, obesity and chronic kidney disease are some contributing factors cited in the report.

Volgman, who is also the medical director of the Rush Heart Center for Woman at the Rush University Medical Center in Chicago, said that lifestyle changes — including dietary choices, physical activity, and smoking habits — can make a big impact.

“This is why we wanted to increase the awareness about lifestyle changes that can decrease their risk of diabetes and the deleterious lipid panel,” she said.

An earlier study noted that South Asians often consume vegetables, lentils, rice, wheat chapattis (Indian bread), milk, and yogurt. For cultural and religious reasons, many also subscribe to a vegetarian or vegan diet which results in the avoidance of lean meat and increase of carbohydrates and saturated fats.

Because the vegetable-rich diet common among South Asians does not exactly translate to lower carbs or bad cholesterol, the report also pointed at the consumption of traditional whole grains, which were more common in their diet back in the early 1900s.

Volgman also recommended further studies that would investigate the role of the environment on genes specific to South Asians. She pointed out that researchers often studied the cardiovascular health of Asian Americans altogether, potentially missing out differences between subgroups.

“East Asians greatly outnumber South Asians in the United States. East Asians as a group are at a lower risk of heart disease than are South Asians and Filipinos,” she said.

For this reason, the report mentioned the need for “cultural competency” among clinicians.

“Future studies should focus on increasing representation of South Asians in clinical trials and elucidating genetic and pharmacogenetic differences specific to South Asians to enhance precision medicine efforts.

“Clinicians have to demonstrate ‘cultural competency’ not only when it comes to understanding the increased risk of ASCVD in South Asian patients but also when making recommendations on diet and lifestyle modification.

“Clinicians should be able to provide South Asian patient–specific recommendations and resources on dietary changes, physical activity, and medications to these high-risk patients.”

Access the full report here.

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