People of South Asian descent have more than two-fold the risk of developing heart disease compared with individuals of European ancestry, but this is not being reflected in heart risk calculators, research shows.
Using data from the UK Biobank prospective cohort study, US researchers examined the records of 8,124 middle-aged participants of South Asian ancestry and 449,349 participants of European ancestry, all of whom were free of heart disease when they enrolled.
Over a median follow-up of 11 years, 6.8% of individuals of South Asian descent experienced a heart attack, coronary revascularisation or ischemic stroke, compared with 4.4% of people of European ancestry, equating to an adjusted hazard ratio of 2.03.
‘This higher relative risk was largely consistent across a range of age, sex and clinical subgroups,’ the study authors reported in Circulation.
However, they found heart risk calculators used in the US and Europe predicted nearly identical 10-year heart disease risk for individuals of South Asian and European ancestry.
Hypertension, diabetes and central adiposity explained a greater proportion of risk for atherosclerotic cardiovascular disease in South Asian compared with European individuals.
Yet, even after researchers accounted for a range of potential clinical, anthropometric and life-style factors, South Asian individuals remained at increased risk of heart disease compared with European descendants.
’These results confirm and extend current guidelines to consider South Asian ancestry a risk-enhancing factor in assessing future risk for atherosclerotic cardiovascular disease,’ the study authors wrote.
‘Whether a targeted intervention can attenuate the outsized impact of diabetes or central adiposity among South Asians warrants further attention.
‘Residual risk that persisted after accounting for a range of potential mediators may relate to differences in social determinants of health, unmeasured risk factors, and genetics and warrants further investigation.’
People in the South Asian ancestry group were defined as those who self-reported being of Indian, Pakistani or Bangladeshi origin, or who reported other South Asian heritage, such as their country of birth as Bhutan, Maldives, Nepal or Sri Lanka.
European ancestry was based on self-identification as being white British, white Irish, or any other white European background.
Earlier this month, it was found that almost 2.5million people could have missed out on vital diabetes check ups, according to Diabetes UK.