Original article
Coronary heart disease in South Asians overseas: A review

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Abstract

Coronary heart disease rates have been reported in several parts of the world to be unusually high in people originating from the Indian subcontinent. High coronary disease rates appear to be common to South Asian groups of different geographical origin, religion, and language. This presents a challenge to the understanding of coronary heart disease: the high rates in South Asians are not explained on the basis of elevated serum cholesterol, smoking or hypertension. Low plasma HDL cholesterol, high plasma triglyceride levels and high prevalence of non-insulin-dependent diabetes have been consistently found in South Asians overseas: this probably reflects an underlying state of insulin resistance. Further studies are needed to determine whether this metabolic disturbance can account for the high rates of coronary heart disease in South Asians, and to identify possibilities for prevention.

References (131)

  • A. Keys et al.

    Serum cholesterol responses to changes in the diet. III. Differences among individuals

    Metabolism

    (1965)
  • M.S. Jacobson

    Cholesterol oxides in Indian ghee: possible cause of unexplained high risk of atherosclerosis in Indian immigrant populations

    Lancet

    (1987)
  • G.J. Miller et al.

    Plasma high-density lipoprotein concentration and development of ischaemic heart disease

    Lancet

    (1975)
  • T. Gordon et al.

    High density lipoprotein as a protective factor against coronary heart disease. The Framingham Study

    Am J Med

    (1977)
  • B. Petersson et al.

    Premature death and associated risk factors in urban middle-aged men

    Am J Med

    (1984)
  • I. Thomas et al.

    Serum lipids of Indian physicians living in the U.S. compared to U.S.-born physicians

    Atherosclerosis

    (1986)
  • N. Saha

    Serum high-density lipoprotein cholesterol, apolipoprotein A-I, A-II and B levels in Singapore ethnic groups

    Atherosclerosis

    (1987)
  • T. Poon-King et al.

    Prevalence and natural history of diabetes in Trinidad

    Lancet

    (1968)
  • J.H. Fuller et al.

    Coronary heart disease risk and impaired glucose tolerance: the Whitehall Study

    Lancet

    (1980)
  • J.M. Olefsky et al.

    Reappraisal of the role of insulin in hypertriglyceridemia

    Am J Mod

    (1974)
  • C. Kondapi

    Indians Overseas 1838–1949

    (1951)
  • H. Tinker

    A New System of Slavery

    (1974)
  • G.B. Lomas

    Census 1971: the Coloured Population of Great Britain

    (1974)
  • E.J.B. Rose

    Colour and Citizenship

    (1969)
  • A.J. Chen

    Recent trends in the mortality and morbidity of cardiovascular diseases

    Ann Acad Med Singapore

    (1980)
  • A.M. Adelstein

    Some aspects of cardiovascular mortality in South Africa

    Br J Prev Soc Med

    (1963)
  • C.H. Wyndham

    Trends with time of cardiovascular mortality in the populations of the RSA for the period 1968–1977

    S Afr Med J

    (1982)
  • M. Sorokin

    Hospital morbidity in the Fiji islands with special reference to the saccharine disease

    S Afr Med J

    (1975)
  • J. Tuomilehto et al.

    Cardiovascular diseases in Fiji: analysis of mortality, morbidity and risk factors

    Bull WHO

    (1984)
  • H. Tunstall Pedoe et al.

    Coronary heart attacks in East London

    Lancet

    (1975)
  • M.G. Marmot et al.

    Immigrant Mortality in England and Wales 1970–1978

  • R. Balarajan et al.

    Patterns of mortality among migrants to England and Wales from the Indian subcontinent

    Br Med J

    (1984)
  • L.J. Donaldson et al.

    Patterns of Asian and non-Asian morbidity in hospitals

    Br Med J

    (1983)
  • R.E. Lawrence et al.

    Acute myocardial infarction in Asians and whites in Birmingham

    Br Med J

    (1985)
  • P.J. Lowry et al.

    Coronary artery disease in Asians in Birminghm

    Br Heart J

    (1984)
  • P.M. McKeigue et al.

    Mortality from coronary heart disease in Asian communities in London

    Br Med J

    (1988)
  • B.H. Agarwal

    A reappraisal of pattern of cardiovascular disorders in India

    J Indian Med Assoc

    (1975)
  • S.L. Malhotra

    Epidemiology of ischaemic heart disease in India with special reference to causation

    Br Heart J

    (1967)
  • S.G. Sarvotham et al.

    Prevalence of coronary heart disease in an urban population in northern India

    Circulation

    (1968)
  • B.D. Dewan et al.

    Epidemiological study of coronary heart disease in a rural community in Haryana

    Indian Heart J

    (1974)
  • L.D. Ostrander et al.

    Electrocardiographic findings among the population of a total natural community: Tecumseh, Michigan

    Circulation

    (1965)
  • P.M. McKeigue et al.

    Diabetes, hyperinsulinaemia and coronary risk factors in Bangladeshis in East London

    Br Heart J

    (1988)
  • D. Yach et al.

    Smoking and health in South Africa

    S AFr Med J

    (1988)
  • R. Balarajan et al.

    British smoking and drinking habits: variation by country of birth

    Commun Med

    (1986)
  • A. Silman et al.

    High dietary fat intake and cigarette smoking as risk factors for ischaemic heart disease in Bangladeshi male immigrants in East London

    J Epidemiol Commun Health

    (1985)
  • T.W. Meade et al.

    Haemostatic function and cardiovascular death: early results of a prospective study

    Lancet

    (1977)
  • G.J. McCay et al.

    Dietary and other characteristics relevant for coronary heart disease in men of Indian, West Indian and European descent in London

    Atherosclerosis

    (1988)
  • S.P. Gupta et al.

    Hypertension and blood pressure trends in the general population of Haryana (based on total community surveys)

    J Assoc Physicians India

    (1979)
  • N. Islam et al.

    Hypertension in the rural population of Bangladesh—a preliminary survey

    Bangladesh Med Res Counc Bull

    (1983)
  • C. Florey et al.

    Blood pressure levels of Guyanese adults of African and Indian origin

    Am J Epidemiol

    (1971)
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    P. M. McKeigue was supported by a Wellcome Training Fellowship in Clinical Epidemiology during the preparation of this article.

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