Indians living in the U.S. at higher risk for stroke and heart disease

South Asians residing in the United States are more likely to die from heart disease, such as heart attacks and strokes caused by atherosclerosis as compared to East Asians and non-Hispanic whites of the U.S., according to a new scientific statement released by the American Heart Association published in the journal Circulation.

The statement is developed by a writing group comprising of Annabelle S. Volgman, professor of medicine at Rush Medical College, and colleagues. The statement provides an overview of the behaviors that influence the risk factors for stroke and heart disease among South Asians living in the U.S. based on a review of existing scientific research.

"Statistics about heart disease and stroke risk among Asians can be deceiving when all people of Asian ethnicity are combined into one group. Overall, Asians are at a lower risk for heart disease and stroke compared to people of European ancestry. But when you look at South Asians - both immigrants and people of South Asian ancestry born in the United States - their risk for heart disease and stroke is higher than people from East Asia and people of European ancestry," said Volgman.

More than 3.4 million people who identify themselves as South Asians live in the United States, and about 80 percent come from India. Others come from Bangladesh, Bhutan, the Maldives, Nepal, Pakistan and Sri Lanka. This group includes both immigrants and people of South Asian ancestry who were born in America, according to the United States Census.

Compared to people of European ancestry South Asian Americans:

• have a greater risk of having severe atherosclerosis - the narrowing of the arteries that underlies most heart disease and strokes;


• are more likely to have multiple segments of their arteries narrowed by atherosclerosis;


• have higher levels of artery-clogging LDL cholesterol and triglycerides and lower levels of HDL (good) cholesterol, which predispose the arteries to develop fatty deposits in artery walls that cause them to narrow;


• have a higher level of calcium deposits, a marker for atherosclerosis, if they are of Indian ancestry and over age 60;


• are more likely to have diabetes, which is believed to accelerate atherosclerosis; and


• develop diabetes at a younger age.

The statement also focuses on behavioral factors that may increase the risk of developing atherosclerosis among South Asian Americans and suggests ways that they can be changed to improve health.

According to Volgman, the factors contributing to increased susceptibility of South Asian Americans include consumption of saturated fats from tropical oils - such as palm and coconut oil - and refined carbohydrates, - such as sugar, white bread, and highly processed foods.

Ongoing studies are looking into improving diet quality among South Asians by reintroducing traditional whole grains which were once a mainstay of diet in the region, in addition to suggesting replacing ghee with monounsaturated oils, such as olive, corn or other oils.

South Asian Americans also engage in less physical activity than other minority group members, according to the statement "As healthcare providers, we need to do a better job of helping our South Asian patients understand the importance of exercise, because many don't realize how important it is to their health," said Volgman.

The authors cite studies that suggest that community programs that encourage South Asians to exercise and reduce stress through yoga and Bollywood dancing or other culturally specific physical activities are likely to be more successful than other forms of physical activity. South Asians represent one of the fastest growing ethnic groups in the U.S. The statement concludes with a call to action to include more South Asians in research studies to better understand how to reduce their risk for heart disease and stroke.

For more information click on the link: https://doi.org/10.1161/CIR.0000000000000580