New studies show that people of South Asian ancestry are more than twice as likely to develop heart disease as people of European ancestry, but clinically used to guide decisions about the prevention or treatment of heart disease. Risk Assessment Calculator May Not Be able to Explain Increased Risk Published Today in American Heart Association Leading Journal circulation..
About a quarter (1.8 billion) of the world’s population is of South Asian descent, with a higher proportion of South Asians, according to previous surveys. heart Illness compared to people of most other ethnic groups.
To better understand the variables surrounding the risk of heart disease in people in South Asia ancestor, Researchers evaluated data from a subset of UK Biobank study participants who did not have atherosclerotic cardiovascular disease when enrolled in the study between 2006 and 2010. The analysis included 8,124 participants of South Asian descent and 449,349 of European descent. Their average age was 57 years and was followed on average 11 years. People in South Asian ancestral groups are defined as those who self-reported to be from India, Pakistan, or Bangladesh, or who reported other South Asian heritage sites, such as birthplaces in Bhutan, Maldives, Nepal, Sri Lanka, etc. it was done. European ancestors were based on self-identification as the background of Caucasian British, Caucasian Irish, or other Caucasian Europeans.
Researchers compared the incidence of cardiovascular disease (a procedure that restores a normal blood supply to the heart, a heart attack, stroke, or heart) in people of South Asian descent to the proportion of people of European descent.
They found 4.4% of those who reported having European ancestry, while 6.8% of South Asian ancestral participants had cardiovascular disease events. After adjusting for age and gender, this represents a risk that is more than twice as high for people of South Asian descent. Higher relative risk was nearly consistent across different ages, genders, and clinical subgroups. However, this increased risk was not captured by the clinical estimates used in the United States or Europe.
“Based on previous studies, we predicted that South Asians would have a higher incidence of heart disease. In fact, the American Heart Association now describes South Asian ethnicity as a’risk enhancer’that goes beyond standard risk calculators. We see, “said senior research author Amit V. Kera, MD, M.Sc. He is a cardiologist at the Corrigan Minehan Heart Center and a leader in a research group within the Center for Genomic Medicine at Massachusetts General Hospital in Boston.
“We were surprised at its size Increasing risk“Even in modern clinical practice, it is more than doubled, and how much remains unexplained by traditional clinical or lifestyle risk factors,” he said. It is possible that South Asians were not included in the development of tools in the United States and that this group missed the opportunity to prevent heart attacks and strokes. In this population, intensive control of risk factors such as high cholesterol and type 2 diabetes is even more important. “
A higher percentage of people in the South Asian study group have more risk factors for heart disease, including type 2 diabetes (even in the absence of obesity), high blood pressure, and increased central fat disease (abdominal fat). I did. However, even if researchers explained the known risks, the risks for South Asian ancestors were still 45% higher than for European ancestors.
Dr. Aniludda P. Patel, MD, Fellow of Cardiology at Massachusetts General Hospital and lead author of the study, said: hospital. “Because individuals are grouped by race rather than ancestors, their ability to use public databases to survey South Asia and other general populations in the United States is limited, which has led to rapid growth. These disparities between South Asian populations can be recognized and addressed. The United States is more difficult. In addition to hiring more South Asians in clinical trials and cohort studies, hospital data With better reporting of ancestors in addition to race in the system Electronic medical record It will help you better understand and target these disparities. “
Research has some limitations. The study included adults between the ages of 40 and 69 living in the United Kingdom, so the results may not be generalized to young individuals or people living in other countries. In addition, based on the data, those who volunteered to study UK Biobank were known to be healthier than the general population. Heart disease In both ancestor groups. In addition, research participants’ medical records were reviewed electronically rather than manually, which may have resulted in underreporting.
As part of a NIH-funded consortium, Khera et al., As part of an NIH-funded consortium, of international researchers to aggregate the data and expertise needed to develop new personalized genetic risk estimators in South Asia. We have formed a team. When it comes to clinical risk estimation tools, South Asians are severely underestimated to date, accounting for only about 1% of the individuals studied.
circulation (2021). DOI: 10.1161 / CIRCULATIONAHA.120.052430
American Heart Association
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