- Coronary artery disease (CAD) among Asian Indians can be broadly categorized into 3 distinct forms:
- Type I or malignant type occurs in young individuals (<50 years) with marked prematurity and severity. This type is accompanied by the absence or low levels of traditional risk factors and high prevalence of emerging risk factors, particularly high levels of lipoprotein(a).
- Like type I diabetes, type I CAD develops very early in a person’s life and occurs even in the absence of unhealthy lifestyle choices. The excess CAD mortality among Asian Indians is primarily due to an excess of type I CAD, which accounts for 35% to 40% compared to 5-10% among all other populations.
- Type II occurs in older individuals (>65 years) with high levels of traditional risk factors and low levels of emerging risk factors. This type is no different from CAD in other populations and the severity is usually mild to moderate.
- Type III or mixed variety occurs between the ages of 50 and 65 and is accompanied by varying combinations of conventional and emerging risk factors. 1
- The traditional risk factors include: high cholesterol, obesity, physical inactivity, high blood pressure, smoking, and diabetes.
- The emerging risk factors include: lipoprotein(a),homocysteine, plasminogen activator inhibitor (PAI-1), CRP (C-reactive protein), dysfunctional HDL, etc.
1. Enas EA. How to Beat the Heart Disease Epidemic among South Asians: A Prevention and Management Guide for Asian Indians and their Doctors. Downers Grove: Advanced Heart Lipid Clinic USA; 2010.