Sharodiya Anjali 2005 - Pujari

__________________________________________________________________Durga Puja 2005
Dr. Sarita Kansal
M.D., MPH
Coronary Artery Disease
(CAD) should now be considered
an important public health problem
in immigrant Indians. It is a part of
the epidemiological transition
characterized by changing
lifestyles and a probable genetic
predisposition The high rates of
CAD in Asian Indians appears to
be a global phenomenon, shared by
the inhabitants of the four
countries of the Indian
subcontinent (India, Pakistan,
Bangladesh and Sri Lanka) as well
as immigrants from these countries
to various regions of the world.
The CAD rates among overseas
Asian Indians worldwide are 50%
to 400% higher than people of
other ethnic origin irrespective of
gender, religion, or social class.
Whereas the CAD rates halved in
the West in the past 30 years, the
rates doubled in India with no
signs of a downturn yet. Among
Asian Indian men, about half of all
MI occur under the age of 50 and
25% under the age of 40.
The high rates of CAD in Asian
Indians are due to a combination of
nature (genetic predisposition) and
nurture (lifestyle factors). The
lifestyle factors include those
associated with affluence and
urbanization as well as
immigration and acculturation.
Urbanization is accompanied by
decreased physical activity and
increased consumption of fat
Dr. Kansal is a board certified cardiologist with advanced level III training in echocardiography and
board certified in Nuclear Cardiology. Born in India, she received her medical degree from Maulana
Azad Medical College, New Delhi. Dr. Kansal completed her internship and residency at Southern
Illinois University in 1997 and was on faculty as assistant professor until 2000. She subsequently did
her cardiology fellowship at Vanderbilt University and a fellowship in echocardiography at Emory
University. Dr. Kansal joined Cardiovascular Medicine, P.C. in September 2004. She is also Clinical
Assistant Professor of Medicine at Emory University. Dr. Kansal is a Cardiologist at Cardiovascular
Medicine, P.C. in Marietta. She sees patients by appointment. Phone 770-424-6893.
Double Jeopardy from Nature & Nurture
resulting in “metabolic syndrome”.
This syndrome consists of
dyslipidemia, glucose intolerance,
central obesity, and hypertension.
However, apart from metabolic
syndrome, they have no excess of
conventional risk factors such as
cigarette smoking, hypertension,
and high cholesterol levels. Nearly
half of them are life-long
vegetarians. This excess burden of
premature CAD in Asian Indians is
due to a genetic susceptibility,
mediated through elevated levels of
lipoprotein (a). Lp(a) magnifies the
adverse effects of lifestyle factors
Asian Indians appears to have a
unique pattern of dyslipidemia, a
'deadly lipid tetrad’. This lipid
tetrad consists of elevated Lp(a) in
combination with high LDL, high
triglycerides and low HDL. Lp(a)
levels >40 mg/dL (versus