Indian Americans and other South Asian Americans are more likely to die of heart attacks and strokes, according to a new statement from the American Heart Association released May 24, and published in its journal Circulation.
“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,” said Annabelle S. Volgman, M.D., chair of the statement’s writing group and professor of medicine at Rush Medical College and medical director of the Rush Heart Center for Women in Chicago, Illinois.
“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.
The American Heart Association provided an overview of the behaviors that influence the risk factors for heart disease and stroke among South Asian Americans, based on a review of existing scientific research.
South Asian Americans have a greater risk of having severe atherosclerosis – the narrowing of the arteries that underlies most heart disease and strokes; they are more likely to have multiple segments of their arteries narrowed by atherosclerosis; and 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.
Indian Americans over age 60 have a higher level of calcium deposits, a marker for atherosclerosis. They are more likely to have diabetes, which is believed to accelerate atherosclerosis; and also likely to develop diabetes at a younger age.
Volgman notes that diet is a key factor: many South Asian Americans, even if they are vegetarians, eat a lot of saturated fats from tropical oils – such as palm and coconut oil – and refined carbohydrates, such as sugar, white bread and highly processed foods.
Reintroducing whole grains into the diet, as well as replacing ghee with olive or corn oil, can improve diet quality, noted the American Heart Association.
South Asian Americans also engage in less physical activity than other minority group members, according to the statement: a recent study found that only 49 percent of South Asian Americans believed that exercise was important in preventing heart disease.
“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.
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, noted the authors.
Co-authors of the study are: Latha S. Palaniappan, M.D., (vice-chair); Neelum T. Aggarwal, M.D.; Milan Gupta, M.D.; Abha Khandelwal, M.D.; Aruna V. Krishnan, Ph.D.; Judith H. Lichtman, Ph.D.; Laxmi S. Mehta, M.D.; Hena N. Patel, M.D.; Kevin S. Shah, M.D.; Svati H. Shah, M.D.; and Karol E. Watson, M.D., Ph.D.