1 / 17

South Asians

South Asians face a significantly higher risk of cardiovascular disease due to various interconnected factors. This includes genetic, cultural, and dietary influences that contribute to conditions such as ischemic heart disease and stroke. Key physiological differences, particularly in adipokine activity, further exacerbate these risks. Barriers, including cultural traditions, diet, and language, hinder effective prevention and treatment. It’s crucial for healthcare providers to be aware of these unique challenges, focusing on tailored screening, exercise plans, and lifestyle modifications to improve outcomes in South Asian populations.

dextra
Télécharger la présentation

South Asians

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. South Asians Ashley Marion University of Guelph-Humber Brampton Civic Hospital Cardiac Rehabilitation 0671496 Cardiovascular Disease

  2. Background • Geography • location • Climate • Culture • Diet • Views on exercise • Prevention and awareness • Physiological differences http://www.google.ca/imgres?q=map+of+south+asia&hl=en&sa=X&biw=1280&bih=664&tbm=isch&tbnid=ZetMMCIZNks8iM:&imgrefurl=http://www.southasianconcern.org/south_asians/detail/what_does_south_asian_diaspora_mean/&docid=_DVBn8r4DRN7QM&imgurl=http://www.southasianconcern.org/images/sac_photos/south_asians/south_asia_map.gif&w=420&h=389&ei=eVFwT7TiLNH5ggfbl8xr&zoom=1&iact=hc&vpx=612&vpy=321&dur=1043&hovh=216&hovw=233&tx=112&ty=120&sig=115924055748486242270&page=1&tbnh=132&tbnw=143&start=0&ndsp=20&ved=1t:429,r:10,s:0

  3. What puts South Asians at higher Risk? • INTERHEART case-control study, 52 countries, all ethnic groups, including South Asians • 9 risk factors account for >90% of the population’s noticeable higher risk of MI • smoking, raised apolipoprotein B/apolipoprotein A1 ratio (),hypertension, diabetes mellitus, abdominal obesity, and psychosocial stress

  4. Physiological Differences • Phenotype • Biochemical • Differences in body Characteristics*

  5. Physiological Differences Exp. • Arterial diameter • Altered adipokine activity (leptin, adiponectin) • Inflammation = biomarker of atherosclerosis • Raji et al, • Adiponectin= improves insulin sensitivitygood • Adiponectin levels lower in Asian Indians than in whitesincreased whole body insulin resistance impaired fibrinolysis (process of preventing clots)altered endothelial function • Adipokinesinsulin resistance atherosclerosis

  6. Raji et al

  7. Conditions to take note… • Ischemic Heart Disease • Stroke • Peripheral vascular disease

  8. Stroke • Adiponectin levels lower increased whole body insulin resistance impaired fibrinolysis+ Arterial diameter= Increased number of strokes http://www.cadiresearch.org/?page_id=442

  9. Peripheral vascular disease • What is PVD? • Condition of blood vessels • Leads to narrowing/hardening of arteries • Lower Limbs and feet • Caused by arthrosclerosis • South Asians= increase in atherosclerosis

  10. Ischemic Heart Disease • Aka. Myocardial Ischemia • Heart muscle damage/inefficient • Reduced blood supply to heart • Reduced blood flow=ATHEROSCLEROSIS • Risks • Increases with age • Smokers • Diabetics • HPT

  11. Barriers • What are some of the barriers to working with this population? • Language • Culture and tradition • tradition does not change over-night

  12. Recap • Adipokinesinsulin resistance atherosclerosis • Insulin resistance diminished adiponectin levels

  13. Considerations for Screening/Diagnostics • What do physicians need to consider? • Aware of prevalence of metabolic syndrome and glucose intolerance in South Asians • Screen • waist circumference and waist-hip ratio, rather than BMI. • Assessment of fasting glucose and a complete lipid profile • a strong family history of diabetes, or impaired fasting glucose, an OGTT should be considered

  14. Treatment • no evidence to suggest that treatment targets should differ between ethnic groups. • Exercise* • Diet change • Stress level changes… • Not enough studies with regards to different responses to pharmaceutics

  15. Example Exercise program • Start slowly with aerobics (3 x 30 min with 10 min warm-up and cool down) • Walking, swimming • Cycling for most obese, not as hard on joints • Strength training • Lighter weights higher reps • Continuous • Breath, no max lifts

  16. Barriers to Exercise • Diet • HR? • Beta blockers (HPT) • RPE • Beware starting BP • Strenuous= atherosclerosis • BMI

  17. Work Cited Brookes, Linda (2004). INTERHEART: A Global Case-Control Study of Risk Factors for Acute Myocardial Infarction. Lancet. Retrieved from http://www.medscape.com/viewarticle/489738. Gulshinder, Chattha (2010). Top Ten Risks of the South Asian Diet. Retrieved from http://www.desiblitz.com/content/top-10-risks-of-the-south-asian-diet Gupta, Milan., Singh, Narendra., Verma, Subodh (2006). South Asians and Cardiovascular Risk What Clinicians Should Know. Circulation. 2006; 113: e924-e929. Retrieved from http://circ.ahajournals.org/content/113/25/e924.full#F2 n.a (2012). Peripheral Artery Disease. Medline Plus. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article/000170.htm n.a (2012). Stroke In South Asians. Coronary Artery Disease in Asian Indians. Retrieved from http://www.cadiresearch.org/?page_id=442 Patel, Kiran C R (2004).The Epidemic of Coronary Heart Disease in South Asian Populations: Causes and Consequences; First Edition. Retrieved from http://sahf.org.uk/uploads/docs/files/21.pdf Raji A, Gerhard-Herman MD, Warren M, Silverman SG, Raptopoulos V, Mantzoros CS, Simonson DC. Insulin resistance and vascular dysfunction in nondiabetic Asian Indians. J ClinEndocrinolMetab. 2004; 89: 3965–3972. Retrieved from http://jcem.endojournals.org/content/89/8/3965.abstract?ijkey=8fee1377e4f0b42365c1c2632ff1181012bef892&keytype2=tf_ipsecsha.

More Related