Is the higher risk of cardiovascular disease amongst South Asian populations linked to abnormalities of haemoglobin? A preliminary case control study

“…18 Proof of concept is supported by observations that (i) the oxidative susceptibility of LDL is increased and the protective activity of high-density lipoprotein (HDL) is reduced in thalassaemia, 19 (ii) aberrant haemoglobin metabolism can oxidise LDL, 20 and (iii) haemoglobin abnormalities in South Asians are associated with atherosclerotic disease. 21 With an aim to understand the pathophysiology of heightened CHD risk amongst South Asians, we investigated indices of erythropoietic activity and haemoglobin levels and their relation with CHD risk. We hypothesised that an increasing gradient of haemoglobin and altered erythropoiesis facilitates an atherogenic lipid profile, increasing the oxidation of LDL and sequestration of the biological antioxidant action of HDL (paraoxonase activity).…”

Section: Introductionmentioning

confidence: 99%

Circulating Haemoglobin Levels and the Risk of Atherosclerosis in Asian Indian Populations

et al. 2015

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Background: The global burden of coronary heart disease (CHD) is estimated to be the highest on the Indian subcontinent. The pathophysiology of this increased risk is complex, multifactorial, and its magnitude increases with migration from India to Britain. Haemoglobin disorders, which also frequent this ethnic group, have been linked to cardiovascular disease. We investigated the impact of migration and nutritional intake on haematological parameters amongst South Asians, with a focus on their relation to molecular indices of oxidative atherogenesis. Methods: Haematology, diet, oxidised low-density lipoprotein (LDL), and serum paraoxonase activity were measured in 230 migrant Indian Gujaratis (Britain), and 305 matched contemporaries living in rural villages (India). Results: Median levels of haemoglobin were higher amongst migrant men (14.5 µmol/l) compared to rural men (15.0 µmol/l, P=0.004) and higher in migrant women (12.7 µmol/l) compared to rural women (11.8 µmol/l, P<0.001). Irrespective of site, haemoglobin levels in South Asians were positively associated with high blood pressure, high serum cholesterol, low high density lipoprotein (HDL) cholesterol levels, and increased CHD risk scores (P<0.001). Haemoglobin concentrations were higher amongst migrants compared to rural contemporaries (P<0.001). In rural women, red cell volume was lower, and co-ordinated with lower levels of oxidised LDL compared with migrant women (P<0.001). On multivariate analysis, haemoglobin was independently associated with oxidised LDL (P=0.001) and paraoxonase activity (P=0.025). Conclusion: Levels of haemoglobin were independently associated with indices of atherogenesis in our populations of rural and migrant Indians. Iron availability may underline the pathogenesis for the oxidative modification of LDL in this group.

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Heart failure in the South Asian patient population

Gammon

2014

British Journal of Cardiac Nursing

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Heart failure (HF) is increasing throughout the developed world as a consequence of better survival rates following acute myocardial infarction (MI). South Asian (SA) patients with HF risk poorer outcomes through differing pathophysiological genesis, and a number of cultural and healthcare organisational factors. Nurses have a key role to play in attempting to reduce this potential disease burden among SA HF patients. This article discusses specific nursing care of the SA patient from the perspectives of diagnosis, aftercare, cultural and organisational barriers and tenders suggestions for improving service uptake among members of this marginalised group.

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Is the higher risk of cardiovascular disease amongst South Asian populations linked to abnormalities of haemoglobin? A preliminary case control study

Cited by 3 publications

References 15 publications

Low expression of ferroxidases is implicated in the iron retention in human atherosclerotic plaques

Low expression of ferroxidases is implicated in the iron retention in human atherosclerotic plaques

Circulating Haemoglobin Levels and the Risk of Atherosclerosis in Asian Indian Populations

Heart failure in the South Asian patient population

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