Editorials

Avoiding premature coronary deaths in Asians in Britain

BMJ 1995; 311 doi: https://doi.org/10.1136/bmj.311.7012.1035 (Published 21 October 1995) Cite this as: BMJ 1995;311:1035
  1. Sandeep Gupta, British Heart Foundation junior research fellow in cardiology,
  2. Adam de Belder, Senior registrar in cardiology,
  3. Liam O Hughes, Consultant cardiologist
  1. Department of Cardiological Sciences, St George's Hospital Medical School, London SW17 ORE
  2. King's Healthcare Trust, London SE5 9RS
  3. Norfolk and Norwich Healthcare Trust, Norwich NRI 3SR

    Spend now on prevention or pay later for treatment

    Over 1.5 million people have settled in Britain from the Indian subcontinent (India, Pakistan, and Bangladesh) and east Africa.1 Epidemiological studies have shown that, irrespective of regional, cultural, and religious differences, immigrant south Asians all share a significantly higher mortality from coronary heart disease than the indigenous white population.2 3 4 This increased risk also applies to second generation Asian immigrants who have adverse risk factor profiles for coronary heart disease.5 First recognised in Singapore,6 this increase is a worldwide phenomenon.7 8

    In 1977 a 40% excess incidence of myocardial infarction was found among Asians admitted to hospitals in Leicester,9 and more recently a group from Northwick Park Hospital found that Gujarati Asian men had four times the risk of a first myocardial infarction compared with north European men.10 This study also reported that the Asian men were significantly younger at the time of their first infarct, had more extensive atheroma, and had lower mean cholesterol concentrations than white men.

    Whether the prevalence and incidence of coronary heart disease in Asians living in the Indian subcontinent differ from those in Asians abroad is uncertain. One small study showed no significant differences in risk profiles or extent of coronary disease between Asian men settled in Britain …

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