Coronary Heart Disease in Indians

Coronary Heart Disease in Indians

A report of WHO says that by the end of this century, India would account for more than half of the total heart patients in the world.

Incidence of  CAD in US is 1 %, whereas it was as high as 3 % among Indians and about 7 % among north Indians.

Higher Rate –   2-4 fold higher prevalence of CAD and mortality. Higher rates of clinical events – double than the Whites, 4 fold higher than Chinese.

Greater pre maturity – 5-10 yrs. earlier onset of first myocardial infarction. 5–10 fold higher risk of myocardial infarction and death in the younger age < 40 yrs.

Greater severity – Three vessel disease common even in younger pre menopausal women. Large infarction and greater muscle damage in younger age. 

Lower prevalence of conventional risk factors like hypertension, obesity, cigarette smoking. Cholesterol levels similar to Whites but higher than other Asians.

Higher prevalence of thrombogenic risk factors like – high levels of lipoprotein (a), homocysteine, ApoB, high levels of Triglycerides, fibrinogen, plasminogen activator inhibitor – 1, low levels of HDL.   

The increased incidence of the CAD in the Indians is due to a combination of Nature (genetic predisposition) and Nurture (environmental factors). Because of the genetic predisposition the harmful effects of environmental factors are greatly magnified. Adverse life style factors include those associated with affluence, urbanization and mechanization. When people move from the rural to the urban environment they tend to become sedentary.

Decreased physical activity and increases consumption of calories and saturated fatty acids, insulin resistance and athrogenic dyslipidaemia all add and have synergistic effect on the development of CAD.

Because Indians have higher prevalence of thrombotic risk factors the conventional risk factors become doubly dangerous. 

Lipoprotein(a) elevated levels render many Indians genetically susceptible to CAD as early as childhood. It has been seen that Lp(a) level > 30 mg % is associated with increases

High rate of CAD in Indians are in sharp contrast to  very low rates in other Asians. Despite high rates of smoking and hypertension, CAD rates among both Chinese and Japanese are about 4 fold lower than in US.

The low rate of CAD in Chinese despite high rates of other risk factors is attributed to their highly Anti-Atherogenic Lipid Profile. 

In a study the typical levels in rural China were:

  •  Cholesterol: 127 mg /dl
  • LDL: 63 mg /dl
  • Triglycerides: 100 mg /dl
  • HDL: 44 mg /dl
  • TC/HDL ratio : 2.9

Others have reported cholesterol levels as low as 80 mg /dl in some Chinese communities, where CAD is virtually non existent.

Following are some observations of a Berkeley study: –

Indians around the globe have highest rate of heart disease, usually 2 to 3 times higher than Americans, Europeans, Chinese and Japanese.
Indo Americans are at a higher risk of heat disease in spite of the fact that half of them are vegetarians and lack many of the traditional risk factors related to the heart disease.
About 25 % of the heart attacks among the Indian descent occur when they are younger than 40, unheard of in other populations.
Among those younger than 30 years of age, the coronary artery disease mortality is three fold higher than Whites in UK and 10 fold higher than Chinese in Singapore.


Advertisements
This entry was posted in Medical Tidbits and tagged by Manbir & Gurpreet. Bookmark the permalink.

About Manbir & Gurpreet

Gurpreet Kaur’s journey in this world .... Gurpreet Kaur was a Musician. She was a singer and a composer of music. Her interest was composing and singing Gurbani Shabads in Indian Classical style. She sang Shabads in All the Raags mentioned in Sri Guru Granth Sahib Ji. She also taught Gurmat Sangeet at Gurmat Gian Missionary College, Jawadi, Ludhiana. Elder child to Pushpinder Kaur and Dr. Brig. Harminder Singh, was born in Amritsar on 13th Jan 1962. She attended various convent schools as a child because her father would get frequent Army postings as a dental surgeon. She graduated with Music Honors from Govt. College for Women, Chandigarh. Music was her hobby and she composed and sang Raag based Gurbani Shabads. Doing Kirtan was part of growing up nurtured by her parents. She learned music from her father Dr. Brigadier Harminder Singh who was a dental surgeon in Indian Army and a very good singer himself. Gurpreet’s Bhua (father’s sister), Ajit Kaur retied as a Head of Department of Music from Govt. College for Women Ludhiana, and was a renounced Punjabi singer of her time. Gurpreet Kaur also learned nuances of Indian Classical Music from Pandita Sharma. She was a mother of three children, and a grandmother. Her daughter Keerat Kaur is a Computer Engineer. Her two sons Gurkeerat Singh and Jaskeerat Singh are doctors in USA. Her daughter Keerat Kaur too was part of her group ~ Gurmat Gian Group. Gurpreet Kaur left this world at the age of 54yrs on 12th Sept 2016 in Baltimore USA. She had recorded around 25 cds of Gurbani Keertan. 'Raag Ratan' Album (6 CDs) is a Compilation of Shabads in All the 31 Sudh Raags of Sri Guru Granth Sahib Ji. 'Gauri Sagar' Album (3 CDs) is a Compilation of All forms of Raag Gauri in Sri Guru Granth Sahib Ji. 'Nanak Ki Malhaar' ~ ((3 CDs) is an album of Raag Malhar Shabads in various forms of Malhar. 'Gur Parsaad Basant Bana' ~ (3 CDs) is an album of Shabads in Raag Basant sung in various forms of Raag Basant. Har Ki Vadeyai Sarni Aayea Sewa Priya Kee Preet Piyaree Mohan Ghar Aavho Karo Jodariya Mo Kao Taar Le Raama Taar Le Tere Kavan Kavan Gun Keh Keh Gawan Mera Baid Guru Govinda Saajanrraa Mera Saajanrraa

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google+ photo

You are commenting using your Google+ account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s