Pravasi Herald

Why Asian Indians are more prone to developing coronary artery disease than other groups?

By Navin Nanda, M.D.

Professor of Medicine and Director, Heart Station/Echocardiography Laboratories, University of Alabama at Birmingham, Birmingham, Alabama. Although Dr. Navin Nanda is internationally famous as an expert and innovator in echocardiography, he has also done pioneering studies in coronary artery disease in Asian Indians right from the time he was a Medical Resident at Seth G.S. Medical College and King Edward Memorial Hospital in Mumbai, India. He is the Founding President of the American Association of Cardiologists of Indian Origin and Past President of the American Association of Physicians of Indian Origin. He is currently the President of the International Society of Cardiovascular Ultrasound.

* Two facts stand out:
1) The incidence of coronary artery disease in Asian Indians is 2 to 5 times higher at all ages than Whites, African-Americans, Hispanics and other Asians.
2) It is 5 to 10 times higher in those younger than 40 years. This is not new. For example, my MD thesis from Bombay University prepared 44 years ago in 1966 was on heart attacks in patients under the age of 40 years.

* There are a host of risk factors implicated in the development of coronary artery disease in all groups. These include high blood pressure, diabetes mellitus, high blood cholesterol level, (increased “bad” or LDL cholesterol and decreased “good” or HDL cholesterol), obesity (especially abdominal), high blood triglyceride level from high saturated fat diet, sedentary life style, smoking, family history of coronary artery disease, procoagulant state (increased risk of clot formation), pollution, stressful life, to name some of them.

Many of the above factors are similar to other racial groups. However, others are more prevalent in Asian Indians. One which stands out more than others is diabetes. This is much more common in Asian Indians, has reached epidemic proportions in India and the country has the world’s largest diabetic population. Again, this is not new. For example, in 1967 we published a study from India in the New England Journal of Medicine that documented the relation of heart attacks to high blood sugar levels and showed that heart attacks triggered the development of diabetes in some of these patients. A common thread in most of the studies conducted in Asian Indians living in India as well as other parts of the world such as Africa, United Kingdom and West Indies is the presence of overt or latent (hidden) diabetes and insulin resistance. There is mounting evidence that Asian Indians may have a genetic predisposition to diabetes and coronary artery disease.

A recent survey of Asian Indians conducted at the Swami Narayan Temple in Atlanta, Georgia, showed similar findings. Asian Indians also typically have higher levels of “bad” cholesterol and lower levels of “good” or protective cholesterol. In the young (under the age of 40) Asian Indians we studied in the sixties, we found they were thin and not overweight but had high cholesterol levels, a substantial number were smokers and showed effects of pollution (“arcus senilis” or white circles in the cornea of their eyes).

Studies in Birmingham, Alabama itself have shown that Asian Indians living here have higher prevalence of smaller and denser lipoprotein (fat) particles in their blood as compared to white Americans. These particles are considered an important risk factor for the development of coronary artery disease. Asian Indians living in Birmingham have also been found to have increased platelet activation and fibrinogen in their blood as compared to whites. Both of these factors make the blood more prone to clotting and clot formation in coronary arteries result in heart attacks.

Conclusion: Higher prevalence of several risk factors most likely account for the increased incidence of coronary artery disease and heart attacks in Asian Indians.

Posted by ks on 03/01/10 at 12:15 AM
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Osteoporosis

By Prameela Goli, M.D; F.A.C.R.

Practicing Rheumatologist in Birmingham, AL, Specializing in Treatment of Arthritis, with Special Interest in Osteoporosis, Rheumatoid Arthritis, and Lupus. Phone: (205) 877-2552

ABOUT OSTEOPOROSIS

Osteoporosis is a condition in which bones have lost minerals, especially calcium, making them weaker, brittle, and susceptible to fractures (broken bones). Any bone in the body can be affected by osteoporosis, but the most common places where fractures occur are the back (spine), hips, and wrists. Each year osteoporosis causes an estimated 1.5 million fractures. Fractures may also reduce a person’s ability to lead an active life. It is estimated that 1 out of every 2 women over the age of 50 will be affected by osteoporosis in her remaining lifetime.

Posted by ks on 01/07/10 at 05:47 AM
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The Open Secret Of Weight Loss: Calories In & Calories Out

By PJ Prakash, Ph.D.

Dr. PJ Prakash holds a Ph.D. in Human Nutrition from the University of Rhode Island (U.S.A.) and a Post-Doctorate in Human Nutritional Biochemistry from the Tufts Medical School, Boston (U.S.A.). He previously worked as a nutrition scientist at the USDA Human Nutrition Research Center on Aging at Tufts University, Boston where he published several research papers in prestigious nutrition journals. Currently, he is a nutrition consultant and personal weight loss coach ( http://www.healthysouthasians.com) and also a freelance writer in the field of human nutrition.

Extra body weight is being perceived as an epidemic in the United States. The latest data from the National Center for Health Statistics show that 30 percent of U.S. adults 20 years of age and older - over 60 million people - are obese. About 60-65 percent people in the U.S. alone are overweight. This increase is not limited to adults. The percentage of young people who are overweight has more than tripled since 1980. Among children and teens aged 6-19 years, 16 percent (over 9 million young people) are considered overweight.

Posted by ks on 10/30/09 at 06:58 PM
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Diabetes Mellitus

By Prakash Kansal,
MBBS, FRCPE, FACP, FACC (Retired Faculty, University of Alabama at Birmingham)

This article is going to discuss Type 1 and Type 2 Diabetes Mellitus (DM) only.

It is estimated that approximately 18 million people have DM in USA.

Definition:
Diabetes Mellitus (DM) means high blood glucose (sugar). Fasting (after 8 hour without food) blood glucose (FBG) of 126 mg/dl (100ml) or over or random blood glucose of 200 or over (times 2) with symptoms (described below) is indicative of diabetes.

Posted by ks on 08/31/09 at 04:40 AM
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Significance Of Protein Intake In Weight Loss

By PJ Prakash, Ph.D.

Dr. PJ Prakash holds a Ph.D. in Human Nutrition from the University of Rhode Island (U.S.A.) and a Post-Doctorate in Human Nutritional Biochemistry from the Tufts Medical School, Boston (U.S.A.). He previously worked as a nutrition scientist at the USDA Human Nutrition Research Center on Aging at Tufts University, Boston where he published several research papers in prestigious nutrition journals. Currently, he is a nutrition consultant and personal weight loss coach (www.healthysouthasians.com) and also a freelance writer in the field of human nutrition.

Obesity has been increasing with an unprecedented rate in the United States and the rest of the world. There are approximately 65% overweight people in the U.S. and about 33% are clinically obese. This trend is also rising among children and teens. Due to the other health issues related with excess body weight, such as high cholesterol, high blood pressure, diabetes, and cardio-vascular diseases, obesity is perceived as an epidemic.

Posted by ks on 06/20/09 at 11:22 PM
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HEART DISEASE AMONG ASIAN INDIANS

By VASUDEVA R. GOLI, M.D., F.A.C.C.

Dr. Goli is a practicing Cardiologist with Cardiology PC at Birmingham Baptist Princeton Hospital, Birmingham, AL

The intent of this communication is to raise awareness about the high prevalence of heart disease in the Asian Indian community and to make a few suggestions regarding life style modifications for the prevention of heart disease.

Asian Indians around the world have the highest rate of coronary artery disease (CAD); the most common form of heart disease, although half of the population is life long vegetarians. One out of every 10 Asian Indian adults in the United States has CAD, compared to 1 out of every 30 American Whites. When compared to Whites, Blacks, Hispanics, and other Asians, heart disease in Asian Indians is 2 to 4 times higher at all ages and 5 to 10 times higher in the young (under 40 years of age). Heart disease is an “equal opportunity disease”, and you don’t have to be an NRI or a nonvegetarian to qualify for this vulnerability.

According to the latest statistics, 10% of Indians in New Delhi now have CAD, identical to Asian Indians around the world. Heart disease among Asian Indian physicians is three-fold higher compared to the general U.S. population. These rates were even higher in the Kaiser Permanente study which showed four-fold higher hospital admissions for heart disease in Asian Indians when compared to other ethnic groups. Studies also indicated that stress from immigration and cultural adaptation cannot explain this world wide phenomena. The most striking features of CAD in Asian Indians, especially in the young, is in its accelerated course resulting in a very severe, extensive, and rapidly progressive disease.

Posted by ks on 04/18/09 at 10:47 AM
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