Mortality from coronary heart disease is especially high among people born in the Indian subcontinent. Recently an article written by Dr Srinath Reddy (Cardiology, AIIMS) and Anbumani Ramadoss (health minister of India), in the Lancet(2005http://www.aippg.net/forum/viewtopic.php?t=24097 ) quotes, “ Compared with all other countries, India suffers the highest loss in potentially productive years of life, due to deaths from cardiovascular disease in people aged 35–64 years (9·2 million years lost in 2000). 
By 2030, this loss is expected to rise to 17·9 million years—940% greater than the corresponding loss in the USA , which has a population a third the size of India ‘s”. There is growing evidence that ethnic Indian immigrants now living in different parts of the world have increased predisposition to cardiovascular disease risk as compared to Caucasians. Part of the reason is the high prevalence of diabetes and glucose intolerance in this group. When people take in more calories than needed, extra calories are stored in adipose (fatty) tissue.
According to a report by John Chambers and colleagues in Lancet (2000) an additional explanation has been offered. Their case-control study shows that in Indian Asians, as in other populations of Europe and North America , moderately raised plasma concentrations of homocysteine are associated with increased risk of coronary heart disease. They have also found, as have others, that plasma concentrations of homocysteine tend to be higher in Asians than in the Caucasians. It has been argued that higher homocysteine concentrations in Asians are a consequence of their lower dietary intake of folate and vitamin B12, these findings point to possible strategies for prevention.
A Canadian Cardiovascular Society consensus 1998 on the prevention of cardiovascular diseases reports that Canadians of South Asian origin (people who originate from India, Bangladesh, Pakistan and Sri Lanka) have high rates of Cardio vascular disease (CVD) yet relatively lower rates of cancer, and Canadians of Chinese origin (people who originate from Mainland China, Hong Kong and Taiwan) have low rates of CVD but relatively high rates of cancer. Preliminary results from the pilot study show intriguing differences in lifestyle factors, dietary intake and metabolic factors among Canadians of South Asian, Chinese and European origin despite a similar ‘acculturation’ period in Canada (approximately 17 years) among immigrant populations.
Some important prevention strategies for our community would be inclusion of smoking prevention or cessation, promotion of a ‘traditional diet’ e.g., high fiber, fish, fruit, vegetable consumption, and low fat consumption and regular physical activity, prevention of increase in body mass index (BMI), and optimal management of diabetes, serum dyslipidemia, hypertension and cardiovascular disease.
By Milan Banerjee PhD
3000 Yonge Street
Toronto