Year: 2020
Type: review
Abstract: Currently, South Asia accounts for a quarter of the world population, yet it already claims ≈60% of the global burden of heart disease. Besides the epidemics of type 2 diabetes mellitus and coronary heart disease already faced by South Asian countries, recent studies suggest that South Asians may also be at an increased risk of heart failure (HF), and that it presents at earlier ages than in most other racial/ethnic groups. Although a frequently underrecognized threat, an eventual HF epidemic in the densely populated South Asian nations could have dramatic health, social and economic consequences, and urgent interventions are needed to flatten the curve of HF in South Asia. In this review, we discuss recent studies portraying these trends, and describe the mechanisms that may explain an increased risk of premature HF in South Asians compared with other groups, with a special focus on highly relevant features in South Asian populations including premature coronary heart disease, early type 2 diabetes mellitus, ubiquitous abdominal obesity, exposure to the world's highest levels of air pollution, highly prevalent pretransition forms of HF such as rheumatic heart disease, and underdevelopment of healthcare systems. Other rising lifestyle-related risk factors such as use of tobacco products, hypertension, and general obesity are also discussed. We evaluate the prognosis of HF in South Asian countries and the implications of an anticipated HF epidemic. Finally, we discuss proposed interventions aimed at curbing these adverse trends, management approaches that can improve the prognosis of prevalent HF in South Asian countries, and research gaps in this important field.
Source: Circulation Heart Failure
Authors: Pablo Martinez-Amezcua, Waqas Haque, Rohan Khera, Alka M. Kanaya, Naveed Sattar, Carolyn S.P. Lam, Sivadasanpillai Harikrishnan, Sanjiv J. Shah, Namratha R. Kandula, Powell O. Jose, K. M. Venkat Narayan, Charles Agyemang, Anoop Misra, Anne K. Jenum, Usama Bilal, Khurram Nasir, Miguel Cainzos-Achirica
Institutions: Johns Hopkins University, Yale New Haven Hospital, Yale University, University of California, San Francisco, University of Glasgow, University Medical Center Groningen, National University of Singapore, National University Heart Centre Singapore, National Heart Centre Singapore, Sree Chitra Thirunal Institute for Medical Sciences and Technology, Northwestern University, Sutter Medical Center, Sutter Davis Hospital, Emory University, Amsterdam University Medical Centers, University of Amsterdam, National Diabetes Obesity and Cholesterol Foundation, Diabetes Foundation, University of Oslo, Drexel University, Houston Methodist
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Funder: British Heart Foundation
OpenAlex ID: W3088880246