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Photo: Shaju John

Blame it on genes Excessive production of lipoprotein andan unhealthy lifestyle lead to premature heart disease among Indians.

We have it in our genes; that’s what research tells. According to the Coronary Artery Disease among Asian Indians (CADI) Study, people of Indian origin, no matter where they live, have a higher prevalence of heart disease. Indian immigrants are found to have higher risk than the natives. What is even more alarming is that this trend continues among immigrant Indians even three to four generations after they settle abroad. This is in stark contrast to the general tendency of heart disease rates among immigrant populations to blend with that of the native populations within a few generations.

In fact, people from the Indian subcontinent have the world’s highest heart disease rates. The reason for this strange pattern lies at the root cause of heart disease itself – coronary arteries. Our coronary arteries are a little larger than soda straws. And when fatty deposits accumulate in these narrow arteries, which feed the heart, that’s when trouble starts brewing. It is here that our being Indian costs us dearly. Our Indian genes ensure that we produce more of lipoprotein (a) which is a key component in the formation of plaque in coronary arteries.

Making these startling revelations was Dr. Enas A. Enas, the Chicago-based cardiologist leading the CADI study, during his visit to Hyderabad for the recently concluded Cardiologists Society of India (CSI) conference at HIIC. Speaking to the media in a press meet he said, “Many Asian Indians (people from the Indian subcontinent) are in double jeopardy from nature and nurture – nature being the genetically (risk) determined by lipoprotein (a) excess, and nurture being the unhealthy lifestyle. Lipoprotein (a) has been shown to confer a three fold increase in relative risk of premature heart disease in the absence of any other risk factors.”

Added to this genetic predisposition of ours other risk factors multiply the risk. Add smoking or low HDL and our relative risk becomes 8 fold; add hypertension and it becomes 17 fold; add diabetes and our risk becomes 21 fold.

What this means is, as Dr. Enas puts it, “In heart disease terms, a cigarette smoked by an Indian is equivalent to three smoked by a non-Indian. A 30-point rise in cholesterol in an Indian is like a 90-point rise in people of other ethnicities. Ten pounds gained by an Indian equals thirty pounds gained by others.”

We can not change our being Indian. But there is definitely a lot we can do. Heart disease begins right from childhood when fatty deposits begin to accumulate in our coronary arteries. And that’s when healthy lifestyle needs to begin. As Dr. Enas quips, “A 200 pounds mom sitting before TV and munching snacks all day can’t tell her kids to be different. When the father smokes and drinks, the child will do the same. When parents don’t do the right things, children follow.” And that’s where the change needs to begin.

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