Bainey Kevin R, Gupta Milan, Ali Imtiaz, Bangalore Sripal, Chiu Maria, Kaila Kendeep, Kaul Padma, Khan Nadia, King-Shier Kathryn M, Palaniappan Latha, Pare Guillaume, Ramanathan Krish, Ross Stephanie, Shah Baiju R
Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada.
Department of Medicine, McMaster University, Hamilton, and Canadian Collaborative Research Network, Brampton, Ontario, Canada.
CJC Open. 2019 Oct 30;1(6):271-281. doi: 10.1016/j.cjco.2019.09.004. eCollection 2019 Nov.
South Asians (SAs), originating from the Indian subcontinent (India, Pakistan, Sri Lanka, Bangladesh, Nepal, and Bhutan), represent one quarter of the global population and are the largest visible minority in Canada. SAs experience the highest rates of coronary artery disease in Canada. Although conventional cardiovascular risk factors remain predictive in SA, the excess risk is not fully explained by these risk factors alone. Abdominal obesity, metabolic syndrome, and insulin resistance likely contribute a greater risk in SAs than in other populations. The South Asian Heart Alliance has been recently formed to investigate and recommend the best strategies for the prevention of cardiometabolic disease in SAs in Canada. This topic review represents a comprehensive overview of the magnitude of cardiovascular disease in SAs in Canada, with a review of conventional and novel risk markers in the SA population. Both primary and secondary prevention strategies are suggested and when possible, adapted specifically for the SA population. The need for SAs and their healthcare professionals to be more aware of the problem and potential solutions, along with the need for population-specific research, is highlighted.
南亚人(SAs)起源于印度次大陆(印度、巴基斯坦、斯里兰卡、孟加拉国、尼泊尔和不丹),占全球人口的四分之一,是加拿大最大的可见少数族裔。在加拿大,南亚人患冠状动脉疾病的比例最高。尽管传统的心血管危险因素在南亚人中仍具有预测性,但仅这些危险因素并不能完全解释其额外的患病风险。腹部肥胖、代谢综合征和胰岛素抵抗在南亚人中可能比在其他人群中造成更大的风险。南亚心脏联盟最近成立,旨在调查并推荐加拿大南亚人预防心脏代谢疾病的最佳策略。本专题综述全面概述了加拿大南亚人心血管疾病的严重程度,并回顾了南亚人群中的传统和新型风险标志物。文中提出了一级和二级预防策略,并尽可能专门针对南亚人群进行了调整。强调了南亚人及其医疗保健专业人员需要更加了解该问题和潜在解决方案,以及开展针对特定人群研究的必要性。