scholarly journals Evidence for reduced susceptibility to cardiac bradycardias in South Asians compared with Caucasians

Heart ◽  
2018 ◽  
Vol 104 (16) ◽  
pp. 1350-1355 ◽  
Author(s):  
Matthew F Yuyun ◽  
Iain B Squire ◽  
G André Ng ◽  
Nilesh J Samani
Keyword(s):  
Ethnic Group ◽  
South Asian ◽  
Census Data ◽  
South Asians ◽  
Sinus Node ◽  
Implantation Rate ◽  
Incidence Rates ◽  
Underlying Mechanisms ◽  
The Uk ◽  
Risk Ratios

ObjectivesTo investigate ethnic differences in susceptibility to bradycardias in South Asian and white European patients in the UK by determining rates of permanent pacemaker (PPM) implantation for sinus node dysfunction (SND) and atrioventricular block (AVB) in each ethnic group.MethodsWe carried out a retrospective cohort study into new PPM implantation during the period from 1 May 2006 to 31 March 2014, in patients of South Asian and Caucasian ethnicity resident in Leicestershire, UK. Numbers of individuals at risk in each ethnic group were derived from UK National Census data of 2011. Crude, and age-standardised incidence rates and risk ratios per 1000 population of PPM implantation were calculated for Caucasians and South Asians.ResultsDuring the study period, 4883 individuals from the Leicestershire population of 980 328 underwent PPM implantation, a cumulative implantation rate of 4.98/1000 population. The population cumulative PPM implantation rate for SND was 1.74/1000, AVB 2.83/1000 and other indications 0.38/1000 population. The crude incidence in Caucasians (6.15/1000 population) was higher than in South Asians (1.07/1000 population) and remained higher after age standardisation (5.60/1000 vs 2.03/1000, P<0.001). The age-standardised cumulative PPM implantation rates were lower in South Asians for both SND (0.53/1000 in South Asians; 1.97/1000 in Caucasians, P<0.001) and AVB (1.30/1000 in South Asians; 3.17/1000 in Caucasians, P<0.001). Standardised risk ratios (95% CI) for PPM implantation in South Asians compared with Caucasians for all pacing indications, SND and AVB were 0.36 (95% CI 0.36 to 0.37), 0.27 (95% CI 0.27 to 0.28) and 0.41 (95% CI 0.41 to 0.42), respectively.ConclusionsRates of PPM implantation are lower in South Asians residing in the UK, compared with Caucasians. This observation raises the possibility of lower inherent susceptibility to bradycardias in South Asians compared with Caucasians. Studies aimed at identifying underlying mechanisms, including possible genetic differences, are warranted.

Abstract P149: A Large-scale Multi Ethnic Study of a Direct Measure of Insulin Sensitivity Demonstrates That South Asians are the Most Insulin Resistant Ethnic Group in the US

Circulation ◽  
2012 ◽  
Vol 125 (suppl_10) ◽  
Author(s):  
Monica S Divakaruni ◽  
Fahim Abbasi ◽  
Manisha Desai ◽  
Cynthia A Lamendola ◽  
Latha Palaniappan ◽  
...  
Keyword(s):  
Insulin Sensitivity ◽  
Ethnic Group ◽  
Ethnic Groups ◽  
South Asian ◽  
Large Scale ◽  
South Asians ◽  
Insulin Resistant ◽  
The Us ◽  
Resistant Group ◽  
Direct Measures

Introduction: Insulin resistance (IR) is a known risk factor for heart disease. Few studies have compared race/ethnic differences in IR using ‘gold standard’ direct measures of insulin sensitivity. Methods: A total of 892 non-diabetic subjects (548 White, 106 South Asian, 103 East Asian, 86 Hispanic and 49 Black) underwent a 4-hour insulin suppression test (IST) as a part of various IR related studies at Stanford over the last ∼20 years. We used generalized estimating equations assuming an exchangeable correlation structure to determine the association between race/ethnicity and steady state plasma glucose (SSPG) derived from an IST, accounting for correlation of outcomes among subjects from the same study. We similarly determined whether differences in plasma triglyceride (TG) and high-density lipoprotein (HDL) levels among race/ethnic groups could be explained by differences in SSPG. All analyses were adjusted for age, sex, and BMI. Results: Significant differences among the race/ethnic groups in SSPG were observed (p <0.001). South Asians were the most insulin resistant group with a mean increase in SSPG of 38 mg/dL, compared to whites after controlling for age, sex, and BMI, a difference equivalent to ∼1/2 of the standard deviation of SSPG. East Asians were the next most resistant group (mean +33 mg/dl SSPG compared to whites) followed by Hispanics (+20 mg/dl), Whites, and Blacks (−7 mg/dl). South Asians were the only group with significantly higher TG (mean +1.16 fold, p=0.04) and lower HDL (−3.0 mg/dl, p=0.02) levels compared to whites but these differences were no longer evident after controlling for SSPG. In contrast, Blacks had significantly lower TG (mean 0.8 fold, p = 0.006) compared to whites, but this difference was not at all mitigated after adjusting for SSPG. Blacks also had no significant differences in HDL compared to whites. Conclusions: Direct measures of insulin sensitivity suggest that South Asians are the most insulin resistant race/ethnic group in the US even after adjusting for the principal determinants of IR. IR may be largely responsible for differences in TG and HDL observed between South Asian and other race/ethnic groups. The etiologies behind differences in insulin sensitivity across race/ethnic groups remain to be determined.

Disparity in implantable cardioverter defibrillator therapy among minority South Asians in the United Kingdom

Heart ◽  
2020 ◽  
Vol 106 (9) ◽  
pp. 671-676 ◽  
Author(s):  
Amar Mistry ◽  
Zakariyya Vali ◽  
Bharat Sidhu ◽  
Charley Budgeon ◽  
Matthew F Yuyun ◽  
...  
Keyword(s):  
Implantable Cardioverter Defibrillator ◽  
South Asian ◽  
South Asians ◽  
Geographical Differences ◽  
Icd Implantation ◽  
Asian Ethnicity ◽  
Cardioverter Defibrillator ◽  
Tertiary Centre ◽  
Implantation Rates ◽  
The Uk

ObjectiveThere are large geographical differences in implantable cardioverter defibrillator (ICD) implantation rates for reasons not completely understood. In an increasingly multiethnic population, we sought out to investigate whether ethnicity influenced ICD implantation rates.MethodsThis was a retrospective, cohort study of new ICD implantation or upgrade to ICD from January 2006 to February 2019 in recipients of Caucasian or South Asian ethnicity at a single tertiary centre in the UK. Data were obtained from a routinely collected local registry. Crude rates of ICD implantation were calculated for the population of Leicestershire county and were age-standardised to the UK population using the UK National Census of 2011.ResultsThe Leicestershire population was 980 328 at the time of the Census, of which 761 403 (77.7%) were Caucasian and 155 500 (15.9%) were South Asian. Overall, 2650 ICD implantations were performed in Caucasian (91.9%) and South Asian (8.1%) patients. South Asians were less likely than Caucasians to receive an ICD (risk ratio (RR) 0.43, 95% CI 0.37 to 0.49, p<0.001) even when standardised for age (RR 0.75, 95% CI 0.74 to 0.75, p<0.001). This remained the case for primary prevention indication (age-standardised RR 0.91, 95% CI 0.90 to 0.91, p<0.001), while differences in secondary prevention ICD implants were even greater (age-standardised RR 0.49, 95% CI 0.48 to 0.50, p<0.001).ConclusionDespite a universal and free healthcare system, ICD implantation rates were significantly lower in the South Asian than the Caucasian population residing in the UK. Whether this is due to cultural acceptance or an unbalanced consideration is unclear.

scholarly journals Cardiovascular risk knowledge in patients of South Asian origin living with rheumatoid arthritis: data from India and the UK

2020 ◽  
Vol 4 (1) ◽  
Author(s):  
Kanta Kumar ◽  
Suvrat Arya ◽  
Peter Nightingale ◽  
Tom Sheeran ◽  
Amita Aggarwal
Keyword(s):  
Rheumatoid Arthritis ◽  
South Asian ◽  
South Asians ◽  
Demographic Data ◽  
Cvd Risk ◽  
Asian Origin ◽  
South Asian Origin ◽  
Increased Risk ◽  
The Uk ◽  
Risk Knowledge

Abstract Background South Asians have a higher risk of cardiovascular disease (CVD). Rheumatoid arthritis (RA) increases the risk of premature atherosclerosis. We investigated whether there was a substantial difference in the level of CVD risk knowledge among patients of South Asian origin with RA in India and in the UK. Methods In this cross-sectional survey, patients of South Asian origin with RA from India and the UK were recruited from secondary care settings. Data were collected via Heart Disease Fact Questionnaire-Rheumatoid Arthritis (HDFQ-RA), a validated self-completion questionnaire. The HDFQ-RA was translated into Hindi and piloted among patients from South Asian background before use. Additionally, clinical and demographic data was collected. Results Among 118 patients from each country, 84% were female and they had similar age, education level, employment status and co-morbidities. Patients from India had longer disease duration (5.5 years versus 4.1 years (p = 0.012) whereas those from the UK had higher disease activity score (4.0 + 0.8 versus 3.1 + 0.7, p < 0.01). Regarding modifiable risk factors for CVD only 51.2% from India and 51.3% in the UK were aware of them. However, awareness of the link between RA and increased risk of CVD was even more limited (32.8% in India and 34.4% in UK). Conclusion Patients of South Asians origin with RA from both countries had limited knowledge about CVD risk. There is a need to educate them about CVD risk during consultation, as this will result in better outcomes.

Innovation

2020 ◽  
pp. 32-70
Author(s):  
Anusha Kedhar
Keyword(s):  
South Asian ◽  
Social Cohesion ◽  
Cultural Practices ◽  
South Asians ◽  
Cultural Integration ◽  
Dance Company ◽  
Competing Demands ◽  
British Asians ◽  
The Uk

Chapter 1 theorizes flexibility in relation to neoliberal demands for innovation. In the late 1990s, during an era of expanding economic globalization and increasing European integration, Britain capitalized on the diverse cultural practices of its postcolonial communities to showcase the country’s “cool” cosmopolitanism and global investment appeal. However, the state was keen to promote a certain kind of diversity, one that was legible and assimilable. In order to be considered for funding, South Asian dance had to be both diverse (i.e., ethnically marked) and innovative (i.e., ethnically unmarked)—different but not too different. After decades of racial division and growing fears that British Asians were a threat to social cohesion, innovation was key to cultural integration. Balancing the dual demands for innovation and diversity required great flexibility on the part of British South Asian dancers, including the ability to stretch the boundaries of the form through experimentation; to be fluent and versatile in multiple techniques; and to adhere to competing demands to make work that was both culturally distinct and legible to a wider (and whiter) public. This chapter shows how one particular British South Asian dance company, Angika, struck a balance between ethnic particularity and mainstream appeal through an array of flexible choreographic and artistic choices. In doing so, Angika’s performances not only helped audiences reimagine Britain as inclusive, cosmopolitan, modern, and “cool,” but also allayed public fears about South Asians in the UK as unassimilable outsiders.

scholarly journals Phyto-oestrogen intake and plasma concentrations in South Asian and native British women resident in England

2006 ◽  
Vol 95 (6) ◽  
pp. 1150-1158 ◽  
Author(s):  
Dee Bhakta ◽  
Craig D. Higgins ◽  
Leena Sevak ◽  
Punam Mangtani ◽  
Herman Adlercreutz ◽  
...  
Keyword(s):  
South Asian ◽  
First Generation ◽  
South Asians ◽  
Plasma Concentrations ◽  
Protective Role ◽  
Cancer Risks ◽  
Using Data ◽  
Daily Intakes ◽  
The Uk ◽  
Two Populations

Phyto-oestrogens, naturally occurring hormone-like chemicals in plant food, may play a protective role against hormone-related chronic diseases. South Asian migrants in the UK have a lower incidence of hormone-related cancer than their hosts but the extent to which this difference may be due to phytoestrogen intake is not known. The aim was to compare habitual phytoestrogen intake in first-generation South Asian migrant women and native British women. South Asian (n 221) and native British women (n 50) were recruited from general practitioner lists and were asked to provide monthly 24h recalls for a period of 1 year. An enhanced phytoestrogen database was compiled using data from a literature search and unpublished data. A sub-sample of South Asian women (n 100) and the native British women (n 40) also provided blood samples every 3 months during the 1-year period. The median daily intakes (μg/d) of isoflavones (184·2 v. 333·9) and lignans (110·8 v. 148·8) were significantly lower in South Asians than in the native British (P<0·001, P=0·04 respectively).There were no significant differences in mean plasma isoflavone levels (nmol/l) but plasma enterolactone was significantly lower in the South Asians (13·9 (sd17·5) v. 28·5 (SD23·3),P<0·001). The main sources of phytoestrogens were bread and vegetables in both ethnic groups. Habitual phytoestrogen intake in South Asian and native British women was below 1mg/d and was higher in the native British diet. The present study does not support the hypothesis that differences in phytoestrogen intake, or in circulating levels, could explain differences in hormone-related cancer risks between these two populations.

scholarly journals Oral Health Beliefs, Attitudes, and Practices of South Asian Migrants: A Systematic Review

2019 ◽  
Vol 16 (11) ◽  
pp. 1952 ◽  
Author(s):  
Mehak Batra ◽  
Sabrina Gupta ◽  
Bircan Erbas
Keyword(s):  
Oral Health ◽  
Health Beliefs ◽  
South Asian ◽  
Health Knowledge ◽  
South Asians ◽  
Country Of Origin ◽  
Asian Population ◽  
South Asian Population ◽  
Attitudes And Practices ◽  
The Uk

Oral health is a burden among all populations and is linked with major chronic diseases such as cardiovascular diseases. Migrants, in particular South Asians, have poor oral health which requires further understanding to better inform oral health interventions by targeting specific aspects of this heterogenous South Asian population. This review is undertaken to systematically synthesize the evidence of oral health understandings, knowledge, attitudes, beliefs, practices, and behaviors of South Asian migrants residing in high-income countries. A comprehensive systematic search of seven electronic databases and hand-searching for peer-reviewed studies was conducted. All study designs were included, and quality assessment conducted. Of the 1614 records identified, 17 were included for synthesis and 12 were quantitative in design. These studies were primarily conducted in the UK, USA, Canada, and Europe. South Asian migrants had inadequate oral health knowledge, attitudes, and practices—influenced by culture, social norms, and religiosity. In the absence of symptoms, preventive oral hygiene practices were limited. Barriers to access varied with country of origin; from lack of trust in dentists and treatment cost in studies with India as the country of origin, to religiosity, among poorer nations such as Bangladesh. Fewer studies focused on recent arrivals from Bhutan or the Maldives. Culturally and socially appropriate strategies must be developed to target oral health issues and a “one-size” fits all approach will be ineffective in addressing the needs of South Asian migrants.

scholarly journals P206 Cardiovascular risk knowledge in patients of South Asian origin living with rheumatoid arthritis: data from India and the UK

Rheumatology ◽  
2020 ◽  
Vol 59 (Supplement_2) ◽  
Author(s):  
Kanta Kumar ◽  
Suvrat Arya ◽  
Peter Nightingale ◽  
Tom Sheeran ◽  
Amita Aggarwal
Keyword(s):  
Rheumatoid Arthritis ◽  
South Asian ◽  
South Asians ◽  
Demographic Data ◽  
Cvd Risk ◽  
Asian Origin ◽  
South Asian Origin ◽  
Increased Risk ◽  
The Uk ◽  
Risk Knowledge

Abstract Background South Asians have a higher risk of cardiovascular disease (CVD). Rheumatoid arthritis (RA) increases the risk of premature atherosclerosis. Therefore, we compared the level of CVD risk knowledge among patients of South Asian origin with RA in India and in the UK. Methods In this cross-sectional survey, patients of South Asian origin with RA from India and the UK were recruited from secondary care settings. Data were collected via Heart Disease Fact Questionnaire-Rheumatoid Arthritis (HDFQ-RA), a validated self-completion questionnaire. The HDFQ-RA was translated into Hindi and piloted among patients from South Asian background before use. Additionally, clinical and demographic data was collected. Results Among 118 patients from each country, 84% were female and they had similar age, education level, employment status and co-morbidities. Patients from India had longer disease duration (5.5 years versus 4.1 years (p = 0.012) whereas those from the UK had higher disease activity score (4.0 + 0.8 versus 3.1 + 0.7, p &lt; 0.01). Regarding modifiable risk factors for CVD only 44.6% from India and 45.4% in the UK were aware of them (p=ns). However, awareness of the link between RA and increased risk of CVD was even more limited (38.1% in India and 40.7% in UK (p=ns). Conclusion Patients of South Asians origin with RA from both countries had limited knowledge about CVD risk. There is a need to educate them about CVD risk during consultation, as this will result in better outcomes. Disclosures K. Kumar None. S. Arya None. P. Nightingale None. T. Sheeran None. A. Aggarwal None.

scholarly journals Mitigating the identity and health threat of COVID-19: Perspectives of middle-class South Asians living in the UK

2021 ◽  
pp. 135910532110276
Author(s):  
Kristin Hanson ◽  
Emma O’Dwyer ◽  
Sharmistha Chaudhuri ◽  
Luiz Gustavo Silva Souza ◽  
Tushna Vandrevala
Keyword(s):  
High Risk ◽  
Middle Class ◽  
South Asian ◽  
Thematic Analysis ◽  
Minority Groups ◽  
South Asians ◽  
Psychological Theory ◽  
Identity Threat ◽  
South Asian Community ◽  
The Uk

The recognition and representation of BAME community as ‘high risk’ of Covid-19 in the UK presents both a health and an identity threat to this ethnic group. This study employed thematic analysis to explore response to these threats as related by a sample of 13 middle class members of the South Asian community. This work advances both health and identity psychological theory by recognising the affinity between expressions of health efficacy and identity. Our findings identify South Asian intragroup stigmatisation and commonalities that have implications for the promotion of health behaviour and health communications for minority groups.

scholarly journals INFLUENCE OF ACCULTURATION ON THE BRAND SELECTION OF THE SOUTH ASIAN DIASPORA IN THE UK

2017 ◽  
Vol 13 (2) ◽  
Author(s):  
Muhammad Rizwan ◽  
Keyword(s):  
South Asian ◽  
Structural Equation ◽  
South Asians ◽  
Brand Choice ◽  
Target Market ◽  
Quantitative Methodology ◽  
Personal Factors ◽  
The South ◽  
Asian Diaspora ◽  
The Uk

It is found throughout the literature that culture is an important influence on consumer behaviour. Those people who migrate to another country belong to a different class of consumers, who is influenced by home or host culture simultaneously. This study is aimed to explore the influence of acculturation on the brand choice of the South Asian immigrants in the UK. This study used a quantitative methodology to test a proposed model, developed with the help of past studies. A survey instrument was developed to collect data from the South Asian immigrant population living in the UK. Structural equation modelling was used to test the hypotheses. The study found that various personal factors like length of stay in the UK and income positively influence the acculturation, while acculturation decreasing with the increasing age among the South Asians in the UK.This study provides an insight about looking beyond the demographic variables while developing strategies to attract the market segments. The brand marketing management in the UK and other western countries while attracting the diaspora should understand the level of acculturation of their target market. The retailers may also consider the consumer cultural profile while deciding their product mix.

Suicidal Behavior in South Asians in the UK

Crisis ◽  
2002 ◽  
Vol 23 (3) ◽  
pp. 108-113 ◽  
Author(s):  
Dinesh Bhugra
Keyword(s):  
South Asian ◽  
Attempted Suicide ◽  
South Asians ◽  
Asian Women ◽  
South Asian Women ◽  
Hypothetical Model ◽  
Deliberate Self Harm ◽  
Cultural Alienation ◽  
Self Harm ◽  
The Uk

Summary: Rates of deliberate self-harm have been reported to be higher among South Asians, especially women, in the UK. Two studies collected information on inception rates of deliberate self-harm in the UK and reported that rates of attempted suicide are much higher among South Asian women especially those aged 18-24. These rates are associated with high rates of cultural alienation and previous attempts. The implications of cultural conflict are discussed in this context. In addition, a hypothetical model of interrelationship of factors for both adults and adolescents is described.

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