Why Indians? / Why South Asians?

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Demographic data indicate that the heart disease rate among Indians / South Asians is double that of the national averages of the western world. This may be attributed to an underlying genetic predisposition to metabolic deregulation and cardiomyopathy (1-4), as well as a recent shift of modifiable risk factors towards increasing consumption of red meats / saturated fats / trans fats / junk foods and higher stress in sedentary call-center workers in India.

Now on to some Startling Figures about Heart Disease and Stroke among South Asians: 

• Public health estimates indicate that India accounts for approximately 60% of the world’s heart disease burden (5), despite having less than 20% of the world’s population. Heart disease is the number one cause of mortality and a silent epidemic among Indians.
• India, particularly the city of Hyderabad in the state of Andhra Pradesh, is currently the diabetic capital of the world (6). Indians have been affected by high rates of diabetes, metabolic syndrome, hypertension, and smoking. These are major risk factors for cardiac disease.
• When heart disease strikes Indians, it tends to do so at an earlier age (almost 33% earlier) than other demographics, often without prior warning. Furthermore, 50% of all heart attacks in Indian men occur under 50 years of age and 25% of all heart attacks in Indian men occur under 40 years of age, a staggering figure (1, 5, 7-8)! Indian women have high mortality rates from cardiac disease as well.
• Demographic data indicate that the heart disease rate among Indians is double that of national averages of the western world. This may be attributed to an underlying genetic predisposition to metabolic deregulation and cardiomyopathy (2-4), as well as a recent shift of modifiable risk factors towards increasing consumption of red meats / saturated fats and trans fats / junk foods and higher stress in sedentary call-center workers in India.
• A well balanced, heart healthy diet as well as positive lifestyle changes such as exercise, stress reduction techniques, control of hypertension and diabetes, and also quitting smoking may reduce the occurrence of heart disease (9).
• Every six seconds, regardless of age or gender, someone will die from stroke (10). The World Stroke Organization (WSO) has designated October 29 “World Stroke Day” to raise awareness about this “One in Six” campaign. South Asians are at particularly high risk for ischemic and hemorrhagic (bleeding) stroke (11).
• Unlike many developed countries, there is a notable paucity of public health infrastructure and initiatives in India to raise awareness about this important issue (12). To date, few healthcare providers in India routinely screen South Asians for heart disease and stroke risk factors. We can do something about this!

Resources and Further Reading: 

1. Enas EA. How to beat the heart disease epidemic among South Asians: A prevention and management guide for Asian Indians and their doctors. Downers Grove: Advanced Heart Lipid Clinic, 2005.
2. Book: Enas EA. Singh V, Munjal YP, Gupta R, Patel K. Recommendations of the Second Indo-US Health Summit on the prevention and control of cardiovascular diseases among Asian Indians. Indian Heart J 2009;61:265-74.
3. Paper: “Risk Factors for Early Myocardial Infarction in South Asians Compared With Individuals in Other Countries,” Joshi, Islam, Pais, et al: JAMA; Vol. 297 No. 3, January 17, 2007
4. Review Article: Review Paper: “South Asians and Cardiovascular Risk: What Clinicians Should Know,” by Milan Gupta, Narendra Singh and Subodh Verma. Circulation; Journal of the American Heart Association. 2006;113:e924-e929
5. South Asian Heart Center at El Camino Hospital
6. India Current Affairs Article: Hyderabad tops in Diabetes Cases in India.
7. CADI Research Foundation
8. CNN Article Heart Disease on the rise in India
9. American Heart Association
10. South Asian Society on Atherosclerosis and Thrombosis
11. Stroke Association in the UK: Stroke in South Asians
12. Prevent India