Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America

Enas A. Enas, Abhimanyu Garg, Michael A. Davidson, Vinod M. Nair, Beverley A. Huet, Salim Yusuf

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Abstract

The prevalence of coronary heart disease (CHD) and its risk factors in first-generation Asian Indian immigrants to the United States of America (US) were compared with those of the native Caucasian population. A total of 1688 Asian Indian physicians and their family members (1131 men and 557 women, age >20 years) completed a questionnaire and in 580 subjects serum lipoproteins were determined. The age-adjusted prevalence of myocardial infarction and/or angina was approximately three times more in Asian Indian men compared to the Framingham Offspring Study (7.2 % versus 2.5%; p<0.0001) but was similar in women (0.3% versus 1%; p=0.64). Asian Indians had higher prevalence of noninsulin-dependent diabetes mellitus (NIDDM; 7.6% versus 1%; p<0.0001) but markedly lower prevalence of cigarette smoking (1.3% versus 27%; p<0.0001) and obesity (4.2% versus 22%; p<0.0001). Hypertension was less prevalent in Asian Indian men (14.2% versus 19.1%, p<0.008) but similar in women (11.3% versus 11.4%). The prevalence of elevated total and low-density lipoprotein (LDL) cholesterol levels was similar in men [17% versus 23.4% (p=0.24) and 13.7% versus 22.3% (p=0.22), respectively] but lower in women [15% versus 26.1% (p=0.018) and 14.3% versus 19.6% (p=0.047) respectively]. The mean levels of high-density lipoprotein (HDL) cholesterol were less in younger (30-39 years) Asian Indian men (mean: 0.98 versus 1.18 mmol/l; p<0.001) and middle-aged (30-59 years) women (mean: 1.24 versus 1.45 mmol/l; p<0.001). The prevalence of hypertriglyceridaemia was similar in men (18.5% versus 11.3%), but higher in Asian Indian women (8.3% versus 4.1%, p=0.02). To conclude, immigrant Asian Indian men to the US have high prevalence of CHD, NIDDM, low HDL cholesterol levels and hypertriglyceridaemia. All these have "insulin resistance" as a common pathogenetic mechanism and seem to be the most important risk factors.

Original languageEnglish (US)
Pages (from-to)343-353
Number of pages11
JournalIndian Heart Journal
Volume48
Issue number4
StatePublished - Jul 1996

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Coronary Disease
Type 2 Diabetes Mellitus
Hypertriglyceridemia
LDL Cholesterol
HDL Cholesterol
Lipoproteins
Insulin Resistance
Obesity
Smoking
Myocardial Infarction
Hypertension
Physicians
Serum
Population

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America. / Enas, Enas A.; Garg, Abhimanyu; Davidson, Michael A.; Nair, Vinod M.; Huet, Beverley A.; Yusuf, Salim.

In: Indian Heart Journal, Vol. 48, No. 4, 07.1996, p. 343-353.

Research output: Contribution to journalArticle

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title = "Coronary heart disease and its risk factors in first-generation immigrant Asian Indians to the United States of America",
abstract = "The prevalence of coronary heart disease (CHD) and its risk factors in first-generation Asian Indian immigrants to the United States of America (US) were compared with those of the native Caucasian population. A total of 1688 Asian Indian physicians and their family members (1131 men and 557 women, age >20 years) completed a questionnaire and in 580 subjects serum lipoproteins were determined. The age-adjusted prevalence of myocardial infarction and/or angina was approximately three times more in Asian Indian men compared to the Framingham Offspring Study (7.2 {\%} versus 2.5{\%}; p<0.0001) but was similar in women (0.3{\%} versus 1{\%}; p=0.64). Asian Indians had higher prevalence of noninsulin-dependent diabetes mellitus (NIDDM; 7.6{\%} versus 1{\%}; p<0.0001) but markedly lower prevalence of cigarette smoking (1.3{\%} versus 27{\%}; p<0.0001) and obesity (4.2{\%} versus 22{\%}; p<0.0001). Hypertension was less prevalent in Asian Indian men (14.2{\%} versus 19.1{\%}, p<0.008) but similar in women (11.3{\%} versus 11.4{\%}). The prevalence of elevated total and low-density lipoprotein (LDL) cholesterol levels was similar in men [17{\%} versus 23.4{\%} (p=0.24) and 13.7{\%} versus 22.3{\%} (p=0.22), respectively] but lower in women [15{\%} versus 26.1{\%} (p=0.018) and 14.3{\%} versus 19.6{\%} (p=0.047) respectively]. The mean levels of high-density lipoprotein (HDL) cholesterol were less in younger (30-39 years) Asian Indian men (mean: 0.98 versus 1.18 mmol/l; p<0.001) and middle-aged (30-59 years) women (mean: 1.24 versus 1.45 mmol/l; p<0.001). The prevalence of hypertriglyceridaemia was similar in men (18.5{\%} versus 11.3{\%}), but higher in Asian Indian women (8.3{\%} versus 4.1{\%}, p=0.02). To conclude, immigrant Asian Indian men to the US have high prevalence of CHD, NIDDM, low HDL cholesterol levels and hypertriglyceridaemia. All these have {"}insulin resistance{"} as a common pathogenetic mechanism and seem to be the most important risk factors.",
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AU - Garg, Abhimanyu

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AU - Huet, Beverley A.

AU - Yusuf, Salim

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N2 - The prevalence of coronary heart disease (CHD) and its risk factors in first-generation Asian Indian immigrants to the United States of America (US) were compared with those of the native Caucasian population. A total of 1688 Asian Indian physicians and their family members (1131 men and 557 women, age >20 years) completed a questionnaire and in 580 subjects serum lipoproteins were determined. The age-adjusted prevalence of myocardial infarction and/or angina was approximately three times more in Asian Indian men compared to the Framingham Offspring Study (7.2 % versus 2.5%; p<0.0001) but was similar in women (0.3% versus 1%; p=0.64). Asian Indians had higher prevalence of noninsulin-dependent diabetes mellitus (NIDDM; 7.6% versus 1%; p<0.0001) but markedly lower prevalence of cigarette smoking (1.3% versus 27%; p<0.0001) and obesity (4.2% versus 22%; p<0.0001). Hypertension was less prevalent in Asian Indian men (14.2% versus 19.1%, p<0.008) but similar in women (11.3% versus 11.4%). The prevalence of elevated total and low-density lipoprotein (LDL) cholesterol levels was similar in men [17% versus 23.4% (p=0.24) and 13.7% versus 22.3% (p=0.22), respectively] but lower in women [15% versus 26.1% (p=0.018) and 14.3% versus 19.6% (p=0.047) respectively]. The mean levels of high-density lipoprotein (HDL) cholesterol were less in younger (30-39 years) Asian Indian men (mean: 0.98 versus 1.18 mmol/l; p<0.001) and middle-aged (30-59 years) women (mean: 1.24 versus 1.45 mmol/l; p<0.001). The prevalence of hypertriglyceridaemia was similar in men (18.5% versus 11.3%), but higher in Asian Indian women (8.3% versus 4.1%, p=0.02). To conclude, immigrant Asian Indian men to the US have high prevalence of CHD, NIDDM, low HDL cholesterol levels and hypertriglyceridaemia. All these have "insulin resistance" as a common pathogenetic mechanism and seem to be the most important risk factors.

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