New light on heart disease

(Edmonton) A first-of-its-kind study in Canada has found that South Asians in Alberta with coronary disease experience a lower quality of life—with more frequent and more severe chest pains and less capacity to exert themselves physically—than heart disease patients of European descent.

The study led by Kevin Bainey of the Faculty of Medicine & Dentistry adds to prior data that South Asians typically develop heart disease at a younger age, live with more severe disease and have a higher rate of mortality.

Using the APPROACH registry, which captures information about all patients in Alberta who undergo a coronary angiogram, the research team analyzed data about the quality of life and health status of South Asians. The validated survey results showed a lower score for overall quality of life for South Asians—immigrants or their descendants from India, Pakistan, Sri Lanka, Nepal and Bangladesh.

“It tells us now that not only are we worried about worse clinical outcomes in terms of death and myocardial infarction (heart attack), but we now must be concerned about poor quality of life,” says Bainey. “When diagnosed with coronary disease, South Asians in the community are doing worse and are not satisfied.

“The current data encourage clinicians to pay close attention to South Asians in the community in order to improve their therapy and enhance their quality of life.”

Bainey’s passion for heart health among this group started when he first became a cardiologist and found out that South Asians who have coronary disease typically present at a younger age, live with more severe disease and have a higher mortality. South Asians make up 17 per cent of the world’s population but account for more than 60 per cent of all coronary disease, he says.

“I wanted to see if I could contribute to the research being done on South Asians with coronary artery disease, given that I am from South Asian descent as well,” says Bainey, an interventional cardiologist and clinical researcher in the Faculty of Medicine & Dentistry and Mazankowski Alberta Heart Institute.

“We always focus on the clinical outcomes of death and recurrent heart attack.... But in the current era, we’ve now become quite interested in quality of life and health status, which to me is equally as important.”

Laksiri Goonewardene moved to Edmonton permanently from Sri Lanka in 1984. In 2005, at the age of 58, he suffered a major heart attack that required emergency medical crews to resuscitate him. He later received a stent and an implanted defibrillator.

He hasn’t had problems since, but he has worked hard to make sure he stays healthy.

“I try to control my diet as much as I can, especially the portion size,” says Goonewardene. “Keep a constant weight, take my medication, and exercise....I try to do a bit of walking, especially in the summertime.”

Goonewardene became aware of South Asians’ propensity for heart disease after his own heart attack and thinks it’s vital for people like Bainey to be looking after this group.

“I think by making people aware and helping them change their lifestyles, their eating habits, even before they get these heart attacks, it’s a wise thing to do,” he says.

Bainey will continue his work in the area. He hopes to help educate South Asians about their risks of coronary disease. He’s also spreading word to his colleagues that this group needs closer attention.

“It’s really put into light the ongoing concerns of South Asian patients with coronary artery disease,” says Bainey.

The results of this study are published in American Heart Journal.