South Asian Ethnicity and Cardiovascular Risk

Ahmed, Emad; El‐Menyar, Ayman

doi:10.1177/0003319714541323

Cited by 22 publications

(12 citation statements)

References 113 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…A number of non-conventional risk factors are also thought to partially account for the high risk of CVD in South Asians, including dysfunctional HDL, C reactive protein, thrombogenic risk factors, telomere length, high homocysteine levels and low birth weight. 40 41 Socioeconomic factors could probably also explain some of the differences in risk between the ethnic groups, but we did not have such variables. Another possibility is that risk factors work cumulatively over time in the development of atherosclerosis, and some risk factors may also work at specific and crucial time points during the life course.…”

Section: Discussionmentioning

confidence: 97%

Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies

et al. 2017

View full text Add to dashboard Cite

ObjectivesThe objective was to prospectively examine potential differences in the risk of first cardiovascular disease (CVD) events between South Asians and Europeans living in Norway and New Zealand, and to investigate whether traditional risk factors could explain any differences.MethodsWe included participants (30–74 years) without prior CVD in a Norwegian (n=16 606) and a New Zealand (n=129 449) cohort. Ethnicity and cardiovascular risk factor information was linked with hospital registry data and cause of death registries to identify subsequent CVD events. We used Cox proportional hazards regression to investigate the relationship between risk factors and subsequent CVD for South Asians and Europeans, and to calculate age-adjusted HRs for CVD in South Asians versus Europeans in the two cohorts separately. We sequentially added the major CVD risk factors (blood pressure, lipids, diabetes and smoking) to study their explanatory role in observed ethnic CVD risk differences.ResultsSouth Asians had higher total cholesterol (TC)/high-density lipoprotein (HDL) ratio and more diabetes at baseline than Europeans, but lower blood pressure and smoking levels. South Asians had increased age-adjusted risk of CVD compared with Europeans (87%–92% higher in the Norwegian cohort and 42%–75% higher in the New Zealand cohort) and remained with significantly increased risk after adjusting for all major CVD risk factors. Adjusted HRs for South Asians versus Europeans in the Norwegian cohort were 1.57 (95% CI 1.19 to 2.07) in men and 1.76 (95% CI 1.09 to 2.82) in women. Corresponding figures for the New Zealand cohort were 1.64 (95% CI 1.43 to 1.88) in men and 1.39 (95% CI 1.11 to 1.73) in women.ConclusionDifferences in TC/HDL ratio and diabetes appear to explain some of the excess risk of CVD in South Asians compared with Europeans. Preventing dyslipidaemia and diabetes in South Asians may therefore help reduce their excess risk of CVD.

show abstract

Section: Discussionmentioning

confidence: 97%

Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies

et al. 2017

View full text Add to dashboard Cite

show abstract

“…diabetes, and CVD risks in vegetarians are similar to nonvegetarian SAs and comparable or even excessive relative to people from Western countries (Ahmed and El-Menyar 2014). The majority of our participants were vegetarian, and their daily vegetable and fruit consumption was 7.5 servings, which is greater than the 4.4 servings/day of the general Canadian population (Krueger et al 2017).…”

Section: Discussionmentioning

confidence: 60%

“…Individuals of South Asian (SA) descent are either born in or can trace their ancestry to India, Pakistan, Nepal, Bangladesh, or Sri Lanka. SAs have significantly higher risk for early onset of cardiovascular diseases (CVD) (Joshi et al 2007), hyperinsulinemia, and dyslipidemia compared with other Asians and individuals of European descent (Ahmed and El-Menyar 2014;Rabanal et al 2017;Volgman et al 2018). Also, the mortality risk associated with CVD is higher in SAs compared with Europeans, Americans, other Asians (Ahmed and El-Menyar 2014), or Africans (Chaturvedi 2003).…”

Section: Introductionmentioning

confidence: 99%

“…SAs have significantly higher risk for early onset of cardiovascular diseases (CVD) (Joshi et al 2007), hyperinsulinemia, and dyslipidemia compared with other Asians and individuals of European descent (Ahmed and El-Menyar 2014;Rabanal et al 2017;Volgman et al 2018). Also, the mortality risk associated with CVD is higher in SAs compared with Europeans, Americans, other Asians (Ahmed and El-Menyar 2014), or Africans (Chaturvedi 2003). In addition to the genetic predisposition to chronic disease in this population, the high risk for metabolic disorders can be attributed to the quality of diet and lifestyle choices (Gadgil et al 2015).…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Diet quality and risk factors for cardiovascular disease among South Asians in Alberta

Subhan

Chan

2019

Appl. Physiol. Nutr. Metab.

View full text Add to dashboard Cite

South Asians have a higher prevalence of early onset cardiovascular disease risk compared with other populations. Dietary intake is a modifiable risk factor for cardiovascular disease. Dietary patterns in immigrants and successive generations of South Asians settled in Western countries undergo adaptions. Little is known about the dietary intake of South Asians in Alberta, thus the objective of the present study was to describe the dietary patterns among South Asians and their risks for cardiovascular diseases. A retrospective analysis of data collected from 140 South Asian adults participating in the Alberta's Tomorrow Project was conducted. Dietary intake was assessed using a food frequency questionnaire and the Healthy Eating Index (HEI) was used an indicator of overall diet quality and adherence to dietary recommendations made by Health Canada. Central obesity (70%), hypercholesterolemia (27%), and hypertension (14%) were predominant health conditions observed in the study participants. About 56% and 44% of participants obtained moderate and poor HEI scores, respectively. The diet quality of the majority of participants was inadequate to meet macro-and micronutrient intake recommendations. The high prevalence of poor/moderate diet quality and pre-existing chronic health conditions across all body mass index groups is a cause for concern in this population.Résumé : La prévalence d'apparition précoce du risque de maladie cardiovasculaire est plus élevée chez les Sud-Asiatiques que chez les autres populations. L'apport alimentaire est un facteur de risque modifiable pour les maladies cardiovasculaires. Les habitudes alimentaires des immigrants et des générations successives des Sud-Asiatiques installés dans les pays occidentaux font l'objet d'adaptations. On sait peu de choses sur l'apport alimentaire des Sud-Asiatiques en Alberta; l'objectif de la présente étude est donc de décrire les habitudes alimentaires des Sud-Asiatiques et leurs risques de maladies cardiovasculaires. Une analyse rétrospective des données recueillies auprès de 140 adultes sud-asiatiques participant au Alberta's Tomorrow Project est réalisée. L'apport alimentaire est évalué à l'aide d'un questionnaire sur la fréquence de consommation des aliments; l'indice de saine alimentation (HEI) est utilisé comme indicateur de la qualité globale de l'alimentation et de la conformité aux recommandations alimentaires de Santé Canada. L'obésité abdominale (70 %), l'hypercholestérolémie (27 %) et l'hypertension (14 %) sont les problèmes de santé prédominants observés chez les participants à l'étude. Environ 56 % et 44 % des participants obtiennent respectivement des scores HEI moyens et faibles. La qualité du régime alimentaire de la majorité des participants est insuffisante pour répondre aux recommandations relatives à l'apport en macro et en micronutriments. La prévalence élevée d'une alimentation de qualité pauvre / moyenne et de problèmes de santé chroniques préexistants dans tous les groupes d'indice de masse corporelle est préoccupante dans cette p...

show abstract

“…CHD is the leading single cause of mortality in Europe, responsible for 862,000 deaths a year (Wilkins et al, 2017). However, the disease burden shows no egalitarian pattern and standardised comparisons amongst different ethnicities show that South Asian people have a disproportionately higher CVD prevalence (Scarborough et al, 2010), higher risk of atherosclerotic events (Anand et al, 2000;Gupta & Brister, 2006;Gupta et al, 2002;Joshi et al, 2007;Yusuf et al, 2004;Zahid, Meyer, Kumar, Claussen, & Hussain, 2011), higher rates of hospital admissions (Ahmed & El-Menyar, 2015) and earlier disease onset (Volgman et al, 2018). Such disparity is not limited to British South Asians but is also evident in worldwide migrant South Asians (Fischbacher et al, 2007).…”

Section: Introductionmentioning

confidence: 99%

“I don’t do it for myself, I do it for them”: A grounded theory study of South Asians’ experiences of making lifestyle change after myocardial infarction

Davis

Jones

Johnson

et al. 2020

Journal of Clinical Nursing

View full text Add to dashboard Cite

Aims and objectives To explore South Asians’ experience of choosing and prioritising lifestyle changes during their recovery from first myocardial infarction. Background Coronary heart disease continues to be a leading cause of premature death globally. South Asians’ suffer increased risk of coronary heart disease and have poorer outcomes following myocardial infarction compared to other ethnic groups. Lifestyle modification slows atherosclerosis, and models of behaviour change have been proposed to support such changes. However, little is known about the experiences of South Asians’ when attempting to modify their lifestyle. Design Constructivist grounded theory design, using longitudinal, face‐to‐face, semistructured in‐depth interviews. The consolidated criteria for reporting qualitative research checklist were used to report the study. Method A series of in‐depth interviews with a purposive sample of South Asian patients were conducted at 3 and 16 weeks following hospital discharge. Transcripts were analysed line by line with focused and theoretical coding using the constant comparative method and memo writing. Data collection and analysis occurred simultaneously. Results Three categories characterised the findings. First, patronage of the family, referring to the role that family played in supporting recovery. Conflict often existed between the needs of the family and the individual with the family needs taking priority resulting in lifestyle modifications being abandoned. Second, conforming to beliefs, which explain how religious and health beliefs influenced decisions. Third, affinity towards one's group which refers to the conflictual nature afforded by social norms. The need for “harmony” was identified as the substantive theory. Decisions about choosing and prioritising lifestyle changes were based on what helped participants to maintain harmony in their life rather than meeting individual health needs. Conclusion South Asians’ choose and prioritise lifestyle changes after first myocardial infarction against a backdrop of competing religious, cultural and family beliefs. Relevance to Clinical Practice This paper illustrates that South Asians attempt to balance their individual needs with their family goals, cultural priorities and their religious beliefs when attempting to adopt a healthy lifestyle post myocardial infarction. We propose a model of shared priority setting as a means of promoting behaviour change with South Asians.

show abstract

South Asian Ethnicity and Cardiovascular Risk

Cited by 22 publications

References 113 publications

Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies

Can traditional risk factors explain the higher risk of cardiovascular disease in South Asians compared to Europeans in Norway and New Zealand? Two cohort studies

Diet quality and risk factors for cardiovascular disease among South Asians in Alberta

“I don’t do it for myself, I do it for them”: A grounded theory study of South Asians’ experiences of making lifestyle change after myocardial infarction

Contact Info

Product

Resources

About