What is the risk of coronary heart disease in South Asians? A review of UKresearch

Objective The aim of this study was to systematically review the evidence t hat coronary heart disease risk is higher in South Asians than in comparati ve 'white' populations, particularly seeking studies of incidence. Methods A systematic literature review was carried out using a personal res earch literature collection, MEDLINE 1966-1998 and citations from reference s. Results Of 19 studies, none reported disease incidence. Most studies report ed prevalence, mortality rates or health care utilization data. Most studie s were on people born on the Indian subcontinent, thus omitting the British -born. Several did not report on women. The strongest evidence of an excess of CHD in South Asians came from mortality data comparing those born in th e Indian subcontinent with the whole population of England and Wales. In So uth Asians coronary heart disease is common and important, but neither the actual disease rates nor the excess risk in relation to the 'white' populat ion are known. Both prevalence and mortality data suggested that the freque ncy of coronary heart disease in Indians, Pakistanis and Bangladeshis diffe red. Conclusion Estimates of South Asians' excess risk of coronary heart disease are imprecise and may be too high (if there are data errors) or too low (f or comparison with the general population blunts ethnic variations). South Asians are a heterogeneous group yet most studies of CHD report on Banglade shis, Indians and Pakistanis combined. Indians probably have less CHD than Bangladeshis and Pakistanis. Cohort studies on CHD in South Asians are need ed and these should be designed so that data can be combined for future sys tematic reviews.