Heart risk calculator overlooks increased risk for South Asian ancestors
New studies show that people of South Asian descent are more than twice as likely to develop heart disease as people of European descent, but clinically used to guide decisions about the prevention or treatment of heart disease. Risk assessment calculator may not be able to explain the increased risk published today in the leading journal of the American Heart Association circulation..
About a quarter (1.8 billion) of the world’s population is of South Asian origin, with a higher proportion of South Asians, according to previous surveys. heart disease compared to people of most other ethnic groups.
To better understand the variables surrounding the risk of heart disease in people of the South Asian ancestor, the researchers evaluated data from a subset of UK Biobank study participants who had no 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 and was followed by an average of 11 years. People belonging to South Asian ancestral groups are defined as those who have declared themselves to be from India, Pakistan or Bangladesh, or who have declared other South Asian heritage sites, such as places of birth in Bhutan, Maldives, Nepal, Sri Lanka, etc. Finished. European ancestors were based on self-identification as the origin of Caucasian Britons, Caucasian Irish or other Caucasian Europeans.
The researchers compared the incidence of cardiovascular disease (a procedure that restores normal blood supply to the heart, a heart attack, stroke, or heart) in people of South Asian descent to the proportion of people with European origin.
They found 4.4% of those who reported having European ancestry, while 6.8% of ancestral South Asian participants had events of cardiovascular disease. After adjusting for age and sex, this is more than twice the risk for people of South Asian descent. The higher relative risk was almost constant for different ages, sexes and clinical subgroups. However, this increased risk has not been captured by 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 amplifier” 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 research group leader at 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 tool development in the United States and that this group missed the opportunity to prevent heart attacks and strokes. In this population, control intensive 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 blood pressure. central fat disease (abdominal fat). I did. However, even though the researchers explained the known risks, the risks to South Asian ancestors were still 45% higher than to European ancestors.
Dr Aniludda P. Patel, MD, Cardiology Fellow at Massachusetts General Hospital and lead author of the study, said: hospital. “Because individuals are grouped by race rather than ancestor, their ability to use public databases to study Southeast Asia and other general populations in the United States is limited, which has led to growth fast. 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 Electronic Health Record system will help you better understand and target these disparities . “
Research has certain limitations. The study included adults aged 40 to 69 living in the UK, so the findings may not be generalized to young individuals or to people living in other countries. Additionally, based on the data, those who volunteered to study UK Biobank were known to be healthier than the general population. Heart disease In both groups of ancestors. In addition, the medical records of research participants were reviewed electronically rather than manually, which may have resulted in underreporting.
As part of an 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 novel custom genetic risk estimators in South Asia. We have formed a team. With regard to clinical risk estimation tools, South Asians are to date seriously underestimated, representing only about 1% of the individuals studied.
South Asian Americans at increased risk of heart disease and stroke
circulation (2021). DOI: 10.1161 / CIRCULATIONAHA.120.052430
American Heart Association
Quote: The Heart Risk “Calculator” is a South Asian ancestor acquired from https://medicalxpress.com/news/2021-07-heart-overlook-people-south-asian on July 12, 2021 (7 2021 ). people (March 12). html
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