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Risk factors for acute myocardial infarction in Indians: a case-control study

P Pais1, J Pogue, H Gerstein

  • 1Department of Medicine, St John's Medical College, Bangalore, India.

Lancet (London, England)
|August 10, 1996
PubMed
Summary

Smoking and abdominal obesity are key risk factors for heart disease in South Asians. Reducing these, along with managing blood glucose and hypertension, can help prevent ischaemic heart disease (IHD).

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Area of Science:

  • Cardiology
  • Epidemiology
  • Public Health

Background:

  • South Asians exhibit a higher risk of ischaemic heart disease (IHD), with unclear contributing factors.
  • Existing research primarily focuses on migrants to Western countries, potentially not reflecting the situation for most South Asians in India.
  • This study investigates risk factors for IHD specifically within the South Asian population in Bangalore, India.

Purpose of the Study:

  • To determine the relative importance of various risk factors for ischaemic heart disease (IHD) among South Asians in Bangalore, India.
  • To identify key modifiable and non-modifiable factors contributing to acute myocardial infarction (AMI) in this population.

Main Methods:

  • A prospective, hospital-based case-control study involving 200 patients with first acute myocardial infarction (AMI) and 200 matched controls.

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  • Data collection included diet, smoking habits, alcohol consumption, socioeconomic status, waist-to-hip ratio (WHR), blood glucose levels, serum insulin, oral glucose tolerance tests, and lipid profiles.
  • Main Results:

    • Current smoking (cigarettes or beedis) was the most significant predictor of AMI (OR 3.6), with heavy smokers (≥10/day) showing an OR of 6.7.
    • Hypertension and diabetes mellitus were independent risk factors (OR 2.69 and 2.64, respectively).
    • Elevated fasting blood glucose (OR 1.62 per SD) and abdominal obesity (WHR, OR 2.24 per SD) were strong predictors across all ranges. Higher income and vegetarianism showed a protective effect (OR 0.32 and 0.55, respectively). Lipid profiles were not associated with AMI.

    Conclusions:

    • Smoking cessation is crucial for preventing IHD in Asian Indians.
    • Management of hypertension, reduction of blood glucose levels, and addressing central obesity through lifestyle changes are vital preventive strategies.
    • These findings highlight the importance of targeted public health interventions for cardiovascular disease prevention in South Asian populations.