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PubMed2004

Insulin resistance syndrome (metabolic syndrome) and obesity in Asian Indians: evidence and implications.

OBJECTIVES: This review describes prevalence, determinants, and possible pathophysiologic mechanisms and suggests management and research directions for insulin resistance syndrome (metabolic syndrome) in Asian Indians. METHOD: We reviewed the topic using the terms Asian Indians, Asians, South Asians, and Indians coupled with the terms insulin resistance, hyperinsulinemia, metabolic syndrome, and obesity from the databases Pubmed (National Library of Medicine, Bethesda, MD, USA) and Current Contents (Institute for Scientific Information, Thomson Scientific, Philadelphia, PA, USA) and from non-indexed publications of the medical research and governmental institutions in India. RESULTS: Asian Indians have a high prevalence of insulin resistance syndrome that may underlie their greater than normal tendency to develop diabetes mellitus and early atherosclerosis. Important reasons could be their excess body fat and adverse body fat patterning including abdominal adiposity even when the body mass index is within the currently defined normal limits. Some of these features have been reported at birth and childhood. Whether Asian Indians also have tendency to develop insulin resistance de novo, independent of total or regional adiposity, needs further investigation. Underlying genetic tendency or early-life adverse events may contribute to such a phenotype, but lifestyle factors alone or modulated by inherited factors appear to play an important role because obesity and dyslipidemia become worse with urbanization and migration. Systemic stress may contribute to insulin resistance syndrome in the intra-country and inter-country migrant Asian Indians. CONCLUSIONS: High prevalences of excess body fat, adverse body fat patterning, hypertriglyceridemia, and insulin resistance beginning at a young age have been consistently recorded in Asian Indians irrespective of their geographic locations. These data suggest that primary prevention strategies should be initiated early in this ethnic group.

Asian People↗
PubMed1996

Impaired beta 2-adrenergic agonist-induced venodilation in Indians of Asian origin.

OBJECTIVES: Vascular responsiveness to infusions of vasoactive substances varies between ethnic groups. Indians of Asian origin are a rapidly growing ethnic group in the United States but have not been extensively studied. We sought to determine whether there was any difference in venous responsiveness to a local infusion of vasoactive substances between Indians of Asian origin and white subjects. METHODS: We used the dorsal hand vein compliance technique to construct full dose-response curves to the beta 2-agonist isoproterenol (2 to 270 ng/min) in hand veins preconstricted with phenylephrine in 11 young white subjects and in 11 young Asian Indian subjects. In addition, six subjects in each group were randomly selected to have full dose-response curves to nitroglycerin (0.006 to 1485 ng/min) generated. RESULTS: The maximal response (E(max)) to isoproterenol was smaller in Asian Indians (33.9% +/- 41.1% in Asian Indians versus 107.0% +/- 60.1% in white subjects; p < 0.01). There was no difference in the log of the dose that produced half-maximal venodilation [log(ED50)] between the two groups (1.10 +/- 0.57 in Asian Indians versus 1.15 +/- 0.50 in white subjects). However, nitroglycerin infusion produced similar responses for both the E(max) and the log(ED50) between the two groups. CONCLUSION: These results indicate that differences may exist in beta-adrenergic responsiveness among white subjects and Indians of Asian origin. Therapy for diseases that use beta-adrenergic responses, such as hypertension, must take into account these differential vascular responses because they may affect their efficacy in Asian Indians.

Adrenergic beta-Agonists↗
PubMed2000

Representation of Asian Americans in clinical cancer trials.

PURPOSE: The objectives of this study are to analyze the accrual of Asian Americans to National Cancer Institute (NCI)-supported prevention, screening/diagnosis, and treatment trials and to determine if there is proportional ethnic representation. METHODS: Data were obtained on all participants accrued to ongoing prevention and screening/ diagnosis trials and on all patients accrued to treatment trials from 1994 to mid-1998. In the analysis, the percentage of Asian Americans to the total number of trial participants is calculated. For treatment trials, participants were stratified into five age groups: 0-20 years, 21-44 years, 45-54 years, 55-64 years, and 65 or more years. RESULTS: Asian Americans represented 4.8% of subjects accrued in screening/diagnosis trials, 1.8 to 2.2% of subjects in treatment trials, and 0.9% of subjects in prevention trials. Comparison of treatment trial age groups revealed that younger Asian Americans participate significantly more in treatment trials than older Asian Americans. CONCLUSIONS: Asian American accrual in NCI-supported trials is representative of the cancer burden of Asian Americans in the United States. However, Asian Americans 65+ years are underrepresented. Their full participation in cancer trials is justified.

Adolescent↗
PubMed2001

Larger amounts of visceral adipose tissue in Asian Americans.

OBJECTIVE: Excess visceral adipose tissue (VAT) is recognized as an important risk factor for the development of coronary heart disease and type 2 diabetes. Several studies have reported less VAT in African Americans compared with whites. As little is known about the levels of VAT in Asians, we compared whole-body VAT in Asian Americans with European Americans. RESEARCH METHODS AND PROCEDURES: VAT was measured using whole-body multislice magnetic resonance imaging in 54 women (18 Asian Americans, 36 European Americans) and 53 men (19 Asian Americans, 34 European Americans) with body mass index (measured in kilograms per square meter) < 30. Data were analyzed by multiple regression modeling. RESULTS: Asian American women had higher log-transformed VAT compared with European American women (p < 0.05), after adjusting for age and total body fat. There was a significant age by race interaction such that race differences in VAT were most evident over the age of 30 years. No differences in VAT could be detected between Asian American and European American men, even after adjusting for potential covariates, including total adiposity. DISCUSSION: These data are the first to demonstrate higher amounts of VAT in healthy Asian Americans, a finding that suggests normative VAT values or standards derived from whites may not be applicable to Asians.

Absorptiometry, Photon↗
PubMed1994

A comparison of bone mineral density between Caucasian, Asian and Afro-Caribbean women.

1. We analysed the lumbar spine (L2-L4) and femoral neck bone mineral density results of Caucasian (n = 2232), Asian (Indian sub-continent) (n = 153) and Afro-Caribbean (n = 102) women referred for bone densitometry over a 30 month period. To assess the risk of osteoporosis, the results of Caucasian and Asian women were compared with those of a reference Caucasian population supplied by Lunar. 2. Subject characteristics were similar in all three groups, other than expected ethnic differences in stature and weight. We found that lumbar spine and femoral neck bone mineral density in Caucasians was lower than in Afro-Caribbeans, but higher than in Asians. Consistent with this, bone mineral density was also lower in Asians as compared with the reference Caucasian population, both at the lumbar spine and femoral neck. As a consequence, a higher proportion of Asian women were classified as being at increased risk of osteoporosis than Caucasian women. 3. Since ethnic differences in skeletal size might influence bone mineral density, we also obtained values for bone mineral content in Caucasian and Asian women that were corrected for projected skeletal area, and weight and years since menopause, using regression equations derived from the Caucasian study population. After this analysis, the difference in bone mineral content between Caucasians and Asians at the lumbar spine disappeared, while that at the femoral neck persisted. 4. We conclude that the assessment of risk of osteoporosis in Asian women by comparing bone mineral density with a reference Caucasian population may have limited validity because of the influence of skeletal size on such measurements.

Absorptiometry, Photon↗
PubMed2001

Close relationships between Asian American and European American college students.

The authors examined attitudes and behaviors regarding close relationships between European and Asian Americans, with a particular emphasis on 5 major subgroups of Asian Americans (Chinese, Japanese, Korean, Vietnamese, and Filipino Americans). Participants were 218 Asian American college students and 171 European American college students attending a culturally diverse university. The European Americans did not differentiate among the various subgroups of Asian Americans. Their attitudes regarding close relationships were less positive toward Asian Americans than toward Mexican and African Americans, a finding contrary to the prediction of social exchange theory (H. Tajfel, 1975). In contrast to the European Americans' view of homogeneity among Asian Americans, the 5 major subgroups of Asian Americans expressed a distinctive hierarchy of social preference among themselves. Results are discussed in terms of their implications for future research on interethnic relations involving Asian Americans.

Adolescent↗
PubMed2006

Cancer information seeking preferences and experiences: disparities between Asian Americans and Whites in the Health Information National Trends Survey (HINTS).

Little is known about cancer information needs and seeking patterns in the rapidly growing Asian American population. The purpose of this study is to characterize cancer information seeking behaviors and preferences in Asian Americans and to examine their cancer-related knowledge and risk perceptions. Data from the nationally representative Health Information National Trends Survey (HINTS) database were analyzed to compare non-Hispanic Asians and Whites. Asians had lower awareness of the National Institutes of Health and American Cancer Society, were less likely to think that not smoking or quitting smoking would reduce cancer risk, were less knowledgeable about colon cancer screening, and considered their personal cancer risk to be low. Asians and Whites had similar media usage rates. They also had similar rates of preference for cancer information from various sources, although Asians were significantly more likely to prefer print materials. The level of trust of cancer information from doctors was high overall. This study is limited by under-representation of some demographic subpopulations, future surveys should oversample Asians and strive to include higher-risk Asians (e.g., elderly, poorly educated, immigrants, and those with limited English proficiency).

Adult↗
PubMed2006

Substance abuse1 among Asian Indians in the United States: a consideration of cultural factors in etiology and treatment.

We explore cultural factors that contribute to substance use in the Asian Indian population in the United State and propose culturally sensitive treatment, with an emphasis on family issues. The 2000 U.S. Census figures show that Asian Indians residing in this country have grown to about 1.7 million from the 1990 U.S. Census figure of 815,000. On average, Asian Indians have a higher level of education and proficiency in English compared with many other new immigrant groups. The median family income for Asian Indians in the United State in 1999 was 70,708 US dollars, compared with 53,356 US dollars for Whites. Based on these statistics, Asian Indians are erroneously labeled a "model minority." However, a closer look shows that Asian Indians are paid lower than their White counterparts with comparable education. Also, many Asian Indians live in areas where the cost of living is higher, and high family income does not automatically translate into a higher standard of living. There is large within-group disparities in income, and Asian Indian families might fall at either end of the Socio-economic status (SES) pole.

Adult↗
PubMed2006

Complementary and alternative medicine use among Asian-American subgroups: prevalence, predictors, and lack of relationship to acculturation and access to conventional health care.

OBJECTIVES: Acculturation and access to conventional health care have been found to be predictors of complementary and alternative medicine (CAM) use in the general population. We hypothesized that these factors would be predictors of CAM use in Asian-American subgroups. Because of differences in health and cultural beliefs, we also hypothesized that patterns and predictors of CAM use would vary among Asian-American subgroups. METHODS: Cross-sectional survey of a sample of 9187 adults representative of the California population. RESULTS: Nearly three quarters of Asian-Americans used at least one type of CAM in the past 12 months, which was significantly higher than the national prevalence rate. Chinese Americans had the highest prevalence of any CAM use, whereas South Asians had the lowest prevalence (86% vs. 67%, respectively). Acculturation and access to conventional medical care was unrelated to any CAM use for most Asian-American subgroups. Spirituality was the strongest predictor of any CAM use for most Asian-American subgroups. CONCLUSIONS: CAM use varies across Asian-American subgroups. Acculturation and access to conventional medical care is unrelated to any CAM use for most Asian-American subgroups.

Acculturation↗
PubMed2006

Lower urinary tract symptoms and related help-seeking behaviour in South Asian men living in the UK.

OBJECTIVE: To describe the pattern and prevalence of lower urinary tract symptoms (LUTS) and related help-seeking behaviour in men of South Asian origin living in the UK, and to compare this to the white population. SUBJECTS AND METHODS: Data were obtained as part of the Leicestershire MRC Incontinence Study. Community-dwelling men aged >40 years were sent a postal questionnaire addressing urinary symptoms, bother and help-seeking. Prevalence rates of self-reported LUTS were compared on the basis of the Office of Population Censuses and Surveys ethnic classifications. Logistic regression was used to estimate the relative risk of symptoms between groups. Data from 7810 men were included in the analysis. RESULTS: In all, 409 (5.3%) of the population sample described themselves as Asian; 36.5% of these men described at least one significant LUTS, vs 29.0% of white men. The overall prevalence rates for all storage symptoms were significantly higher in Asian men. Straining to void was the only voiding symptom to show a difference in prevalence between the groups. However, when controlling for age, Asian men were at greater risk for all symptoms except a weak urinary stream. Reported levels of bother and felt need were the same in both population groups, but actual help-seeking was significantly less in the Asian group. Only 25.0% of Asian men had actively sought help, compared to 53.1% of white men. CONCLUSION: South Asian men in the UK have a higher risk of experiencing LUTS than white men from the same population. This increase in risk is greatest for storage symptoms. Although levels of bother are the same, South Asian men are less likely to seek help for their symptoms.

Adult↗
PubMed2006

Acute coronary syndromes and their presentation in Asian and Caucasian patients in Britain.

OBJECTIVE: To describe and compare demographics and symptom presentation in Asian and Caucasian patients with acute coronary syndromes. DESIGN: Long-term prospective survey of symptom presentations in two racial groups. SETTING: A London hospital. PARTICIPANTS: A consecutive series of patients admitted to hospital with acute coronary syndromes between November 2001 and November 2005. MAIN OUTCOME MEASURE: Comparison of demographics and location, character, intensity and symptom distribution at presentation between Asian and Caucasian patients. RESULTS: Asian patients were younger than Caucasian patients (61 v 69 years, p<0.001) and more had diabetes (43% v 17%, p<0.001). Proportionally, more Asian patients had angina (51% v 37%, p<0.001), but more Caucasian patients had myocardial infarction (63% v 49%, p<0.001) and non-ST elevation infarcts (40% v 29%, p<0.001). Men reported smaller areas of discomfort than women. Asian patients more frequently reported discomfort over the rear of their upper bodies compared to Caucasian patients (46% v 25%, p<0.001) and radiation of discomfort to their arms and necks. A higher percentage of Asian than Caucasian patients demonstrated a "classical" location of symptoms (90% v 82%, p<0.001). Patients with diabetes were more likely to feel no discomfort. A higher percentage of Caucasian than Asian patients presented with "silent" events (13% v 6%, p>0.001), with age being a major determinant. CONCLUSION: Asian patients were younger, more likely to be diabetic and tended to report a higher intensity of pain and over a greater area of their body, and more frequent discomfort over the rear of their upper thorax than Caucasian patients.

Acute Disease↗
PubMed2005

Breast cancer survival in South Asian women in England and Wales.

STUDY OBJECTIVES: To estimate ethnic and socioeconomic differences in breast cancer incidence and survival between South Asians and non-South Asians in England and Wales, and to provide a baseline for surveillance of cancer survival in South Asians, the largest ethnic minority. SETTING: 115 712 women diagnosed with first primary invasive breast cancer in England and Wales during 1986-90 and followed up to 1995. METHODS/DESIGN: Ethnic group was ascribed by a computer algorithm on the basis of the name. Incidence rates were derived from 1991 census population denominators for each ethnic group. One and five year relative survival rates were estimated by age, quintile of material deprivation, and ethnic group, using national mortality rates to estimate expected survival. MAIN RESULTS: Age standardised incidence was 29% lower among South Asian women (40.5 per 100 000 per year) than among all other women (57.4 per 100 000). Five year age standardised relative survival was 70.3% (95%CI 65.2 to 75.4) for South Asian women and 66.7% (66.4 to 67.0) for other women. For both ethnic groups, survival was 8%-9% higher for women in the most affluent group than those in the most deprived group. In each deprivation category, however, survival was 3%-8% higher for South Asian women than other women. CONCLUSIONS: This national study confirms that breast cancer incidence is substantially lower in South Asians than other women in England and Wales. It also provides some evidence that South Asian women diagnosed up to 1990 had higher breast cancer survival than other women in England and Wales, both overall and in each category of deprivation.

Age Distribution↗
PubMed2005

Stigma beliefs of Asian Americans with depression in an internet sample.

OBJECTIVE: To study the beliefs of Asian Americans with depression about stigma associated with depression treatment among friends, employers, and family. METHOD: Participants completed the Center for Epidemiologic Studies-Depression Scale (CES-D) anonymously on the Internet. In this cross-sectional design, those who screened positive for depression were asked questions regarding stigma (n = 68 656). We used analysis of variance (ANOVA) and analysis of covariance (ANCOVA) to compare Asian Americans with whites and also to make comparisons by age and sex. Further, we stratified for Asian Americans and used ANOVA and ANCOVA to compare age and sex. We used linear regression to assess how stigma beliefs were associated with self-reported need for depression treatment. RESULTS: Asian Americans overall had greater stigma beliefs than did whites for all 3 stigma outcomes (P < 0.001), especially those related to family. Although this same pattern existed for subjects aged between 16 and 29 years and between 30 and 45 years (P < 0.001), among those aged under 16 years, this existed for family stigma (P < 0.001) but not for friends or employer stigma. In our stratified analyses among Asian Americans, male participants had greater stigma beliefs than did female participants for friends (P < 0.001) and employer (P < 0.05) but not for family. CONCLUSIONS: The pattern of Asian Americans having greater stigma levels than whites may be changing among younger Asian Americans because of acculturation. Also, among Asian Americans, unlike previous research showing no sex differences for stigma, we show that male participants had greater stigma levels than did female participants. Future directions should include measuring stigma after culture-specific interventions.

Acculturation↗
PubMed2004

Insulin resistance and vascular dysfunction in nondiabetic Asian Indians.

Asian Indians are at higher risk for diabetes and cardiovascular disease than European Caucasians. To examine the pathophysiology of this increased risk, we measured insulin sensitivity, cardiovascular risk factors, fat distribution, and endothelium-dependent (reactive hyperemia) and -independent (nitroglycerin) vasodilation before and after a 2-h hyperinsulinemic clamp (40 mU/m(2).min) in 25 nondiabetic Asian Indians and 15 Caucasians with similar age and body mass index. Asian Indians had higher fasting insulin than Caucasians (6.7 +/- 0.8 vs. 3.7 +/- 0.3 microU/ml, P = 0.007) but similar FPG (90 +/- 2 vs. 88 +/- 2 mg/dl). Glucose uptake during the clamp was markedly reduced in Asian Indians vs. Caucasians (4.5 +/- 0.3 vs. 7.5 +/- 0.4 mg/kg x min, P < 0.0001). During the clamp, basal brachial artery diameter increased less in Asian Indians vs. Caucasians (2.6 +/- 1.0 vs. 5.7 +/- 1.0%, P = 0.04), and the reduction was correlated with the impairment in insulin sensitivity (r = 0.38, P = 0.04). In contrast, vasodilatory responses to reactive hyperemia and nitroglycerin were similar in Asian Indians and Caucasians both before and during hyperinsulinemia. Plasminogen activator inhibitor-1 and FFA were significantly elevated and adiponectin was significantly lower in Asian Indians vs. Caucasians, and there were trends toward higher low-density lipoprotein and triglycerides, lower high-density lipoprotein, and increased total, sc, and visceral fat. These risk factors were all significantly correlated with insulin sensitivity. Thus, apparently healthy Asian Indians have severe insulin resistance, dyslipidemia, elevated plasminogen activator inhibitor-1, impaired insulin-mediated vasodilation, and trends toward altered body fat distribution. These abnormalities may contribute to the increased risk of diabetes and cardiovascular disease in this population.

Abdomen↗
PubMed1996

Asian women are at increased risk of gestational thyrotoxicosis.

Gestational thyrotoxicosis is now widely believed to result from excessive thyroidal stimulation by hCG. Our clinical impression has been that this condition is more frequent in Asian women than in those of European origin. To assess this possibility further, we analyzed thyroid hormone levels in the sera of 294 Asian women, obtained as part of a screening program at 15-16 weeks of pregnancy, and compared these with 292 sera from age- and parity-matched European women at a similar time of gestation. TSH levels were significantly lower in the Asian group (P < 0.001). Suppressed TSH levels (< 0.35 mIU/L) were found in 15.7% of Asian women and 4.8% of European women (P < 0.001). In both groups of women with suppressed TSH values, hCG and hCG beta levels were higher than in the women with normal TSH levels. Free T4 levels in the Asian women were significantly higher in those with suppressed TSH (P < 0.001), but this was not found in the European women. There was also a significant increase in the free T3 index in the Asian women with suppressed TSH compared to that in an age-matched group of Asian women with normal TSH levels (P < 0.02), but this was not observed in European women with suppressed TSH. None of the women with suppressed TSH had thyroid-stimulating antibodies. These results show that Asian women more frequently develop biochemical evidence of thyrotoxicosis at the beginning of the second trimester of pregnancy than those of European origin and are, therefore, likely to be at greater risk of clinically apparent gestational thyrotoxicosis and hyperemesis gravidarum. Genetically determined differences in the production or metabolism of hCG isoforms may account for this increased risk.

Asian People↗
PubMed2004

Immigration and acculturation in relation to health and health-related risk factors among specific Asian subgroups in a health maintenance organization.

OBJECTIVES: We sought to determine how risk factors for disease vary among Asian subgroups. METHODS: Using data from a case-control study conducted at Northern California Kaiser Medical Centers (from 1996 to 2001), we compared prevalence of selected risk factors among Asian subgroups and evaluated the associations of these risk factors with sociodemographic factors. RESULTS: Chinese and Japanese patients had a lower body mass index (kg/m(2)) than did other Asians. In all subgroups, being born in the United States was associated with having a body mass index greater than 25 kg/m(2). Compared with other Asians, more Japanese and multiple-race Asians smoked, and more Filipino and multiple-race Asian smokers started smoking at 18 years or younger. Filipinos and multiple-race Asians also were more likely to report diabetes. CONCLUSIONS: These data support the importance of efforts to distinguish among Asian subgroups in public health practice and research.

Acculturation↗
PubMedDate not supplied

The status of tobacco cessation research for Asian Americans and Pacific Islanders.

OBJECTIVES: The purpose of this case study was to describe the status of tobacco cessation research among Asian Americans and Pacific Islanders. METHODS: The author conducted a review of the literature and reviewed studies that he was familiar with. FINDINGS: Tobacco cessation research for Asian Americans and Pacific Islanders has been very scant. Only two peer-reviewed studies focused on smoking cessation research targeted at any Asian American or Pacific Islander population were identified. One of these studies was the Suc Khoe La Vang! ("Health is Gold") intervention funded by the California Department of Health Services to the Vietnamese Community Health Promotion Project at the University of California, San Francisco. This involved a two-year, community-based, controlled trial with multi-component programs such as Vietnamese language media-based activities, Vietnamese language smoking cessation materials written by and for Vietnamese, continuing medical education for Vietnamese physicians. They used a pre-test, posttest design comparing the intervention community of Santa Clara County, CA with the non-intervention community of Houston, TX. After two years, the smoking prevalence rates between the two communities were not significantly different. The other was the "Lay-led Smoking Cessation Approach for S.E. Asian men" funded by the National Heart, Lung, and Blood Institute to The Ohio State University. This particular study was conducted over a six-year period and involved the indigenous model. That is, lay adults from the targeted Cambodian, Laotian, and Vietnamese communities were trained to engage other Southeast Asian men to facilitate their quitting smoking. In comparison to the non-intervened group, the intervention group engaged in more quit attempts and reported a higher rate of smoking cessation (17%) versus the control group (1%). This study demonstrates the potential for successfully initiating quitting attempts but also illustrates the necessity for the intervention to incorporate linguistic, cultural, social environmental, physiological, and cognitive factors in achieving cessation. Furthermore, cessation should be documented not only by self-report but by biochemical verification. The extreme paucity of smoking cessation research for Asian Americans and Pacific Islanders mean that much needs to be initiated, implemented, evaluated, and researched. In so doing, we conclude that Asian Americans and Pacific Islanders are not "hard-to-reach", but hardly reached. CONCLUSIONS: As of February 2001, only two studies relating to tobacco cessation research targeting any Asian American or Pacific Islander populations had been reported in the peer-reviewed literature. Evidences for the effectiveness of these two cases, one in California, and the other in Ohio were cited.

Asian↗
PubMed2001

A comparison of cardiovascular risk factors among Indo-Asian and caucasian patients admitted with acute myocardial infarction in Kuala Lumpur, Malaysia and Birmingham, England.

Indo-Asians in the UK are at an increased risk of coronary artery disease (CAD); this may be a reflection of their cardiovascular risk factor profile as well as of a more sedentary lifestyle. We hypothesised that Indo-Asians in Malaysia and the UK may exhibit a similar cardiovascular risk factor and physical activity profile, which would be more adverse compared with caucasians. We studied 70 consecutive Indo-Asian patients admitted to hospitals in Kuala Lumpur, Malaysia (n=42; 35 males; mean age 60.6 years, SD 11.8); and Birmingham, England (n=28; 20 males; mean age 60.8 years, SD 12.9). Both groups of Indo-Asian patients were compared with 20 caucasian patients (13 males; mean age 62.7 years, SD 9.4) admitted with myocardial infarction from Birmingham. There was a higher prevalence of diabetes among Indo-Asians in both countries than among caucasians (p=0.0225). By contrast, caucasians had a higher prevalence of hypercholesterolaemia (p=0.0113), peripheral vascular disease (p=0.0008), regular alcohol consumption (p<0.0001) and family history of CAD (p=0.0041). There were no significant differences in mean age, body mass index or blood pressures. There was a significantly lower leisure activity score (p=0.001) and total physical activity score (p=0.003) among Indo-Asians in both countries than among caucasians. This survey has demonstrated differences in cardiovascular risk factors among Indo-Asian and caucasian patients. The high prevalence of diabetes, as well as the lower physical activity and sedentary lifestyles among Indo-Asians, in both Malaysia and the UK, may in part contribute to the high incidence of CAD in this ethnic group.

Aged↗