Barriers to Prevention

 Barriers to Prevention among South Asians

  • A majority of South Asians in one study believed that CAD (coronary artery disease) is not preventable and had low awareness of modifiable risk factors.1
  • A study of 270 south Asians in Illinois (2009) showed a poor understanding of the risk factors. Eighty-one percent of respondents had one or more CAD risk factors. Most participants (89%) said they knew little or nothing about CAD. Stress was the most frequently mentioned risk factor (44%). Few mentioned controlling blood pressure (11%); cholesterol (10%); and diabetes (5%) for prevention. Fifty-three percent said that heart attacks are not preventable.1
  • Low education level, being interviewed in Urdu or Hindi, and low level of acculturation were associated with less knowledge and believing that CAD is not preventable.1
  • South Asians are more likely to have evidence of CAD even in the absence of symptoms or clinical findings or have atypical symptoms.2
  • As a first step, CAD education should target the knowledge gaps that may affect risk factor control and behavior change. Educational messages may need to be somewhat different for subgroups (e.g., by education and language) to be maximally effective.1


1. Kandula N. R., Tirodkar MA, Lauderdale DS, Khurana NR, Makoul G, Baker DW. Knowledge gaps and misconceptions about coronary heart disease among U.S. South Asians. Am J Prev Med. Apr 2010;38(4):439-442.

2. Anand SS, Yusuf S, Vuksan V, et al. Differences in risk factors, atherosclerosis, and cardiovascular disease between ethnic groups in Canada: the Study of Health Assessment and Risk in Ethnic groups (SHARE). Lancet. 2000;356(9226):279-284.

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