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Coronary artery disease in South Asians

There is a 40% greater chance of death from heart attacks among South Asians compared to the average populace. As per a WHO report, by 2020, South Asians will account for 25% of the global populace but will suffer more than 50% of the world’s cardiovascular fatalities. Around 25% of heart attacks occur before the age of 40 among young South Asians and 50% occur before the age of 50. On average, South Asians acquire coronary artery disease up to 10 years earlier compared to the general populace.

  • Learn more about CAD in south asians
  • About Preventive Cardiology clinic
Learn more about CAD in south asians

South Asians are more susceptible to coronary artery disease. They face quadruple risk of the disease, and the disease manifests up to 10 years early compared to other ethnicities.

Upwards of 50% of South Asians have their first heart attack before they are 50 years old. In India, cardiac care is reactive, with an individual receiving medical attention when he/she has had an attack. There is a lack of preventive cardiac care, which helps prevent heart attacks and reduce an individual’s cardiac risk. Cardiac rehabilitation focuses on gradually bringing the patient to their optimal heart condition; this is a big area that is not focused on in India.

Recent studies by the WHO indicate India being the global capital for cardiovascular disease (CVC) and diabetes. CVD affects individuals regardless of income level. The lower-middle and middle-class is as susceptible as the rich-class. There is no difference in susceptibility in rural or urban populations either.

Tamil Nadu state has the country’s highest mortality due to cardiovascular disease at 360-430 individuals per 100,000.

Note: These diseases hit the adult population at their most productive ages, which is responsible for an indirect loss to the economy. The WHO estimates a decline in national income by USD 7 billion in 2015 caused due to CVD.

About Preventive Cardiology clinic

Expert cardiologists equip you with the tools and knowledge to maintain cardiac health. Our team follows a comprehensive approach, and patient care consists of a thorough evaluation of the risk factors that may cause heart disease

    At our clinic, you can expect:

  • Customised plans to address your health, lifestyle, and medication, as required
  • Education and counselling programmes to help you adopt a healthy lifestyle
  • Ability to participate in active clinical trials. We keep our research data open – patients may access it
  • Comprehensive heart disease risk assessment
  • Am I At Risk for Heart Disease?
  • Conditions Treated
  • Carotid Artery Disease and Stroke in South Asians
Comprehensive heart disease risk assessment

We evaluate the risk factors and suggest treatment meant to slow down or halt disease progression for health conditions like coronary artery disease, or atherosclerosis.

  • Lipid imbalance
  • Cardio metabolic syndrome indicators
  • Blood pressure
  • Glucose
  • Physical activity
  • Assessment of lipid level and risk indicators such as CRP, Lp (a), and Apo B
  • Risk factor control and lifestyle changes
  • Referrals for appropriate cardiac testing as deemed necessary and appropriate and subsequent assessment of reports
  • Referrals for genetic tests for cardiovascular conditions and following evaluation of reports
  • Cardiac rehab programs, if deemed necessary

Risk factors for men and women differ. We have the Women’s Heart Health clinic dedicated to the treatment of heart disease for women.
Individuals presenting with early-onset cardiac diseases or at a higher risk of coronary disease are provided comprehensive and compassionate care. We also consider the individual’s family who may face potential cardiac health risks.
We target to comprehensively investigate the factors affecting the patient, evaluate risk, and provide treatment and suggest lifestyle changes to reduce the progression of atherosclerosis through primary and secondary prevention measures.
Our experts work on targeted therapy optimised according to the patient’s health condition. Medication and lifestyle modification are suggested, if necessary. We maintain patient health records and communicate digitally, facilitating secure online access to an individual’s medical information.
It is our endeavour to enable you and your family by making you aware of the health challenges and help the community deal well with cardiovascular risks ensuring a healthier life for all.

Am I At Risk for Heart Disease?

Heart disease is the leading cause of death in the United States, irrespective of gender. According to the Centres for Disease Control and Prevention, 1 out of every 4 people dies because of heart disease. However, many kinds of heart conditions can be prevented if the patients and doctors are aware of the signs and can reduce the risk factors. For example, the risk of coronary artery disease, which is the most prevalent heart disease, may be reduced using medication and implementing lifestyle changes.

The following services are offered at the preventive-cardiology clinic

  • Cardiovascular health evaluation
  • Risk factor identification
  • Customised treatment plan to cater to the individual’s lifestyle and needs
  • Nutritional guidance
  • Exercise plan guidance
  • Advanced cardio-vascular imaging facility, if required
  • Comprehensive treatment approach with a team consisting of cardiovascular surgeons and interventional cardiologists
  • Specialist involvement as necessary – diabetologists, vascular surgeons, among others

It is our endeavour to enable you and your family by making you aware of the health challenges and help the community deal well with cardiovascular risks ensuring a healthier life for all.
Another focus area is childhood obesity. We help conduct educational activities in school to educate the students. Our advice includes reduced consumption of processed food and enhancing physical ability.

Conditions Treated

There are different conditions which could be treated with preventive care.

Atherosclerosis

It is a disease that blocks the inner lining of the arteries with plaque. These arteries feed the heart, and their narrowing causes reduced blood flow to the heart.

Cholesterol

Cholesterol deposits accumulate at the lining of the arteries, including those feeding the heart. Constricted arteries cause a reduction in blood flow to the heart.

Coronary artery disease

CAD occurs due to the narrowing or blockage of the arteries of the heart. This blockage may cause angina, congestive heart failure, or heart attack.

Familial hypercholesterolemia

This is a condition where atherosclerosis manifests early. It is a congenital disorder and typically presents with high levels of cholesterol.

Coronary artery disease and insulin resistance in South Asians

  • What is insulin resistance?
    When muscles, fat, and liver cells respond less to insulin, the condition is known as insulin resistance. The cells metabolise glucose/sugar less effectively. To compensate for the reduced metabolism, the pancreas releases a higher amount of insulin in the bloodstream causing higher-than-normal levels. Other problems include:
  • Elevated bad cholesterol levels
  • Lower good cholesterol levels
  • High blood pressure
  • Diabetes
  • Increased risk of blood clotting.
    South Asians are prone to developing coronary artery disease with these factors. Only individuals with diabetes are not at the risk of developing cardiovascular disease.
  • Individuals who have diabetes have a two to four times increased risk of developing heart disease or stroke compared to those without diabetes. Up to 20% of the South Asian population is affected by insulin resistance and diabetes.
  • It is unclear why South Asians present with greater insulin resistance compared to other ethnic groups. It is believed that South Asians may have:
  • Increased hidden fat
  • Low fitness
  • Genetically-linked insulin resistance
Carotid Artery Disease and Stroke in South Asians

South Asia is believed to be the largest contributor of stroke fatalities in the world, with over 40% of global stroke deaths occurring in the region. Stroke-related fatalities could be as higher as for coronary artery disease. In South Asia, both coronary heart disease and stroke occur among a younger populace on average compared to the rest of the world.
Research on the carotid artery disease among South Asians living overseas has shown similar results. The rate of stroke is quite higher in South Asians as against the Europeans. Furthermore, South Asians have greater rates of stroke-related deaths as against the Europeans.

Studies indicate that South Asians face 2-3 fold greater risk of coronary artery disease as against other ethnic factions.
Consequently, there is a higher chance of South Asians having heart attacks, bypass surgery or angioplasty at an early age and are more likely to suffer fatality from the heart attacks.


Heart disease in young South Asians

Around 25% of heart attacks occur before the age of 40 among young South Asians and 50% occur before the age of 50. On average, South Asians acquire coronary artery disease up to 10 years earlier compared to the general populace.



Coronary artery disease in South Asians

There is a 40% greater chance of death from heart attacks among South Asians compared to the average populace. As per a WHO report, by 2020, South Asians will account for 25% of the global populace but will suffer more than 50% of the world’s cardiovascular fatalities.



  • Coronary artery disease and insulin resistance in South Asians
  • Carotid Artery Disease and Stroke in South Asians
Coronary artery disease and insulin resistance in South Asians

What is insulin resistance?

When muscles, fat, and liver cells respond less to insulin, the condition is known as insulin resistance. The cells metabolise glucose/sugar less effectively. To compensate for the reduced metabolism, the pancreas releases a higher amount of insulin in the bloodstream causing higher-than-normal levels. Other problems include:

  • Elevated bad cholesterol levels
  • Lower good cholesterol levels
  • High blood pressure
  • Diabetes
  • Increased risk of blood clotting.


South Asians are prone to developing coronary artery disease with these factors. Only individuals with diabetes are not at the risk of developing cardiovascular disease.

Individuals who have diabetes have a two to four times increased risk of developing heart disease or stroke compared to those without diabetes. Up to 20% of the South Asian population is affected by insulin resistance and diabetes.

It is unclear why South Asians present with greater insulin resistance compared to other ethnic groups. It is believed that South Asians may have:

  • Increased hidden fat
  • Low fitness
  • Genetically-linked insulin resistance]
Carotid Artery Disease and Stroke in South Asians

South Asia is believed to be the largest contributor of stroke fatalities in the world, with over 40% of global stroke deaths occurring in the region. Stroke-related fatalities could be as higher as for coronary artery disease. In South Asia, both coronary heart disease and stroke occur among a younger populace on average compared to the rest of the world.
Research on the carotid artery disease among South Asians living overseas has shown similar results. The rate of stroke is quite higher in South Asians as against the Europeans. Furthermore, South Asians have greater rates of stroke-related deaths as against the Europeans.

Studies indicate that South Asians face 2-3 fold greater risk of coronary artery disease as against other ethnic factions.
Consequently, there is a higher chance of South Asians having heart attacks, bypass surgery or angioplasty at an early age and are more likely to suffer fatality from the heart attacks.

Risk factors of coronary artery disease

  • Insulin resistance, the biggest risk factor for coronary artery disease in South Asians
  • High blood pressure
  • Diabetes
  • Cholesterol abnormalities
  • Metabolic syndrome
  • Smoking
  • Family history of early coronary heart disease

Quick facts about Coronary Artery Disease

  • More than 50% of South Asians have a heart attack before the age of 50.
  • Research indicates that the risk of death following the first heart attack is 40% more for South Asians compared to other ethnicities.

Copyright by Dr. Spoorthi 2019. All rights reserved.