Up to 44% of Indians at heart disease risk: Experts

About 25 per cent-44 per cent of Indians worldwide are at the risk of malignant heart disease from a genetic condition, said veteran cardiologists in the United States, who have been conducting long-term studies of the Indian diaspora.

According to experts, the problem is caused by elevated Lipoprotein(a) levels, which are linked to the DNA of individuals with South-Asian ancestry and subsequently aggravated by diet and lifestyle.

"One way of thinking about this is genetics loads the gun but it is the environment that pulls the trigger," explained Dr Enas A Enas, a Chicago-based cardiologist who is the principal investigator of the Coronary Artery Disease among Asian Indians (CADI) research foundation, which has found a three- to four-fold high rate of coronary artery disease among immigrants from India to the US.

"In comparison, only 20 per cent of Caucasians are at risk and 10 per cent of Chinese,” he added.

Also read: Is there a genetic component to heart disease?

He said Lipoprotein(a) is an inherited genetic variant of low-density lipoprotein (or LDL, also known as “bad” cholesterol), which is now widely recognised as the foremost risk factor for malignant heart disease and which leads to premature deaths under the age of 50.

While awareness about adverse cardiac outcomes is rising in India — heightened recently by the death of actor Puneeth Rajkumar who succumbed to cardiac arrest on October 29 — Dr Naras Bhat, a member of the Physician Advisory Committee of the South Asian Heart Center in Silicon Valley, said similar heart trends had been noticed among Indian-Americans for several years now.

"This applies whether a person is from India or whether the person is of Indian origin from another country,” Dr Bhat said, adding that his youngest patient was a 30-year-old man of Indian ethnicity, originally from Fiji.

“His genetic makeup was the same as that found among others on the Indian subcontinent,” he added, pointing out that genes could also be causing elevated cholesterol levels.

Experts also noted that nearly 50 per cent of people of Indian origin who have a heart problem have normal cholesterol levels. "This is why Lipoprotein profiles should be done as part of cardiac tests because there is no way to avoid cholesterol," said Dr C N Manjunath, director, Sri Jayadeva Institute of Cardiovascular Sciences and Research.

"Only about 30 per cent of cholesterol is added through food intake, the rest is produced naturally in the body," he said.

At the same time, cardiologist Dr Abhijit Vilas Kulkarni of Apollo Hospitals pointed out that Lipoprotein(a) was not properly measured in the country, which means there was no data on the incidence rate for India.

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