Heart disease and diabetes in South East Asians: a rising epidemic

Heart disease affects a significant portion of the global population, with South East Asians facing particular challenges. It’s important to understand this critical public health issue, especially as the risks have often been overlooked.

For many years, heart health risks for South East Asians were obscured by the broader categorization with East Asians, who generally have lower rates of heart disease. Recent research is shedding light on the unique vulnerabilities that South Asians have.

The MASALA study, involving over a thousand South Asian adults aged 40 to 84, is a groundbreaking effort supported by the National Heart, Lung, and Blood Institute, currently underway. This research is essential in uncovering important health insights.

Findings indicate that South Asians may be at increased risk for heart disease due to a tendency to accumulate fat around vital organs, such as the abdomen and heart. This specific fat distribution can lead to inflammation and cholesterol buildup in blood vessels, even among those with normal waist sizes.

Moreover, South East Asians often have smaller heart blood vessels, which can heighten their susceptibility to blockages and increase the likelihood of requiring bypass surgery.

Worryingly, statistics show that 25% of heart attacks occur before age 40 for young South Asians, and 50% before age 50. While these figures are not vastly different from the general population, South Asians typically experience coronary artery disease about a decade earlier.

Alarmingly, they face a 40% higher risk of dying from heart attacks compared to others, with significantly elevated rates of type 2 diabetes being a major contributing factor.

In light of these findings, the American Diabetes Association and the World Health Organization are advocating for adjusted BMI standards for South Asians. They recommend a BMI of 23 for identifying overweight individuals and 27.5 for obesity, aiming for more effective risk detection.

The more novel markers like body roundness index may help reduce the limitations of BMI in risk prediction for South Asians.

Key Points to Consider:

- South East Asians experience a heightened risk of heart disease and diabetes, often despite maintaining a normal body weight.

- For better health outcomes, the recommended BMI for South East Asians is 23, compared to the standard 25 for other populations. A novel marker like body roundness index( BRI) may be more accurate in identifying risks in South Asians.

- Early screening for heart disease and diabetes is crucial, ideally starting in the early 30s, along with tailored risk factor thresholds.

- Open discussions with healthcare providers are vital, as there is often limited awareness of the unique health challenges faced by this community.

- Ongoing research and awareness initiatives are essential to identify specific triggers and address these health concerns.

South East Asians encompass individuals from Indian, Pakistani, Bangladeshi, Nepalese, Bhutanese, Sri Lankan, or Malaysian backgrounds.

If you know someone grappling with early onset heart disease, sharing their story can be a powerful way to raise awareness and promote better health outcomes for all.