The Open Epidemiology
Can Conventional Risk Factors Explain Excess Coronary Artery
Disease Risk in South Asians: Dyslipidemias and Dysfunctional High
Density Lipoprotein (HDL)
Sunita Dodani Pp 55-62
Over the past several years, the overall prevalence and incidence
of cardiovascular diseases in general and coronary artery diseases
(CAD) in particular have declined in the United States (US). However,
among South Asian in general and South Asian immigrants in particular,
a disturbing trend toward high rates of CAD has been noted. This
trend is associated with a high prevalence of conventional risk
factors and metabolic syndrome in this population, yet these conventional
risk factors may not account for the greater CAD risk among SAIs.
A search for additional markers is warranted, to enable early detection
and prevention of CAD in this high risk group. High density lipoprotein
(HDL) is one of the predictor of CAD and is considered to be cardio-protective.
However, some of the recent studies have shown that HDL is not only
ineffective as an antioxidant but, paradoxically, appears
to be pro-oxidant, and has been found to be associated with CAD.
Such HDL is called dysfunctional HDL. More research is required
in South Asians to explore associations with CAD and to enhance
early detection and prevention of CAD in this high risk group. We
present here an overview on risk factors of CAD in general and dyslipidemias
in particular in South Asians. In addition, concepts on dysfunctional
HDL and its impact on CAD are also presented. At the end, recommendations
are made to improve and prevent CAD morbidity and mortality in the
South Asian communities.