Why do People Living in South Asia Have Heart Attacks at a Younger Age?

People from South Asian countries including India, Pakistan, Bangladesh, Sri Lanka, and Nepal have heart attacks at a younger age as compared to their western counterparts. A recent article in the Journal of American Medical Association (JAMA) addresses this issue. It studies the risk factors for early heart attacks in Indians, Pakistanis, Bangladeshis, Sri Lankans, and Nepalis. A significant percentage of first heart attacks are fatal.

While this study focuses our attention on a grim reality, I am very happy to see this study. Studies like this help us focus on the importance of custom-made medicine. This study brings up several points:

•  Some of the South Asian countries like India are progressing rapidly. The prosperity brings its own challenges including sedentary life style and a different kind of malnutrition. A proactive approach to preventing heart and vascular diseases is needed.

• Some studies have shown that one or two small drinks of alcohol daily may decrease the chance of heart problems. The study in JAMA states that lower percentage of people drinking alcohol in South Asian countries may be one of the reasons for heart disease at a young age. It will be a mistake to advise alcohol intake just for cardiac benefits. The risk of addiction will be much higher than benefit to a few who will be able to stick to just one or two drinks a day.
• The study states that people in South Asia consume less vegetable and fruits. Is it because vegetables and fruits are too expensive, eating habits are changing, or there is a lack of awareness of importance of fruits and vegetables?
• It is important to be aware of risk factors for heart disease including high blood pressure, diabetes, high cholesterol, smoking and lack of exercise. First three risk factors are easily diagnosable if looked for.
• A U.S. style war on smoking is needed. This should include: ban on smoking in public places and enclosed spaces, preventing cigarette advertisements, preventing celebrities and cartoon characters from promoting smoking, preventing subtle seductions like having a popular character on TV or in movies smoke. There may be a need to collaborate with passionate anti-smoking agencies in the U.S. to learn from their experience.
• Many people in South Asia are rich by global standard. But I am not sure if some of them will have a fighting chance if they were to have a heart attack in their own town. Time and efficiency is of the essence in treatment of heart attack. There is a need for good emergency response systems and uniformly good treatment standards for the hospitals. There is a need to improve things at grass root levels. Remember: inefficiency of a system affects haves and have-nots equally.

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