Dyslipidemia and Cardiovascular Disease Prevention in South Asians: A Review and Discussion of Causes, Challenges and Management Strategies
- 1 November 2021
- journal article
- review article
- Published by Bentham Science Publishers Ltd. in Current Diabetes Reviews
- Vol. 17 (9), 1-14
- https://doi.org/10.2174/1573399817999210112192419
Abstract
Background: South Asians are at a significantly increased risk of atherosclerotic cardiovascular disease (ASCVD). For a major portion of the South Asian population, the cardiovascular disease events occur at a relatively younger age, are associated with worse outcomes and have potentially more severe socioeconomic implications compared to their western counterparts. Method: The term "South Asian" typically constitutes individuals from India, Pakistan, Nepal, Bhutan, Bangladesh, Sri Lanka, and Maldives and expatriates as well as their families from these countries. Based on this, South Asian form approximately 25% of the world’s population with a high ASCVD burden this group. In this review, we discuss the pathophysiological factors underlying ASCVD in South Asians, the dyslipidemia types and management as well as discuss approaches to improve the overall ASCVD prevention efforts in this large subset population of the world. Although the pathophysiological mechanisms underlying the excess risk of cardiovascular disease in South Asians are multifactorial, dyslipidemia is a primary risk factor for the incidence and prevalence of this disease. The traditional “South Asian” dyslipidemia pattern include levels of low-density lipoprotein cholesterol (LDL-C) in the normal range with high concentration of LDL particles, elevated triglycerides, low levels of high-density lipoprotein cholesterol (HDL-C) with dysfunctional HDL particles, and high levels of lipoprotein(a). Conclusions: While combined efforts to study the expatriate South Asians in western countries have been able to identify South Asian specific dyslipidemias, causal associations and optimal management remains relatively less explored. Larger scale studies are needed to better quantify the relationship of each lipid parameter with ASCVD risk among South Asians as well as optimal lipid targets and management strategies to reduce morbidity and mortality in this high-risk group.Keywords
This publication has 115 references indexed in Scilit:
- Obesity and Inflammation: Epidemiology, Risk Factors, and Markers of InflammationInternational Journal of Endocrinology, 2013
- High Levels of Cardiovascular Risk Factors among Pakistanis in Norway Compared to Pakistanis in PakistanJournal of Obesity, 2011
- Triglyceride-rich lipoproteins and high-density lipoprotein cholesterol in patients at high risk of cardiovascular disease: evidence and guidance for managementEuropean Heart Journal, 2011
- Prevalence and Correlates of Diabetes in South Asian Indians in the United States: Findings From the Metabolic Syndrome and Atherosclerosis in South Asians Living in America Study and the Multi-Ethnic Study of AtherosclerosisMetabolic Syndrome and Related Disorders, 2010
- The Pakistan Risk of Myocardial Infarction Study: a resource for the study of genetic, lifestyle and other determinants of myocardial infarction in South AsiaEuropean Journal of Epidemiology, 2009
- Safety and Efficacy of Statins in AsiansThe American Journal of Cardiology, 2007
- Risk Factors for Early Myocardial Infarction in South Asians Compared With Individuals in Other CountriesJAMA, 2007
- Primary prevention of cardiovascular disease: a web-based risk score for seven British black and minority ethnic groupsHeart, 2006
- Rosuvastatin pharmacokinetics and pharmacogenetics in white and Asian subjects residing in the same environmentClinical Pharmacology & Therapeutics, 2005
- Obesity and insulin resistanceJCI Insight, 2000