6 The World Health Organisation estimated that India lost 8.7 billion US dollars in national income due to combined mortality from CHD, stroke and diabetes in 2005. India experiences amongst the highest number of potentially productive life years lost due to cardiovascular disease 9.2 million years in 2000, expected to double to 17.9 million years by 2030. rural areas ( Figure 1), and compounded by the current rapid rate of urbanization in India, 5 this may result in an underestimation of CHD mortality projections. 3,4 With CHD rates increasing more quickly in urban vs. 2 CHD prevalence is presently twice as high in urban compared to rural India (10–12% vs. This is predicted to increase a further 50% by 2030. Recent estimates from the Global Burden of Disease (GBD) 2010 Study 1 indicate that CHD deaths are highest in South Asia, increasing by 87.8% between 19, second only to East Asia ( Table 1). Indian Asians (people originating from India, Pakistan, Bangladesh and Sri Lanka) comprise one quarter of the globe's population and are at high risk of developing CHD.

Incorporation of these ‘omic’ approaches in prospective Indian Asian cohorts such as the London Life Sciences Population Study (LOLIPOP) provide an exciting opportunity for the identification of new risk factors underlying CHD in this high risk population.Ĭoronary heart disease is the leading cause of death worldwide, responsible for over 7 million deaths annually. Systems biology approaches such as genomics, epigenomics, metabolomics and transcriptomics, provide a non-biased approach for discovery of novel biomarkers and disease pathways underlying CHD. Limited knowledge of mechanisms underlying higher CHD risk amongst Indian Asians presents a major obstacle to reducing the burden of CHD in this population. Genome-wide association studies have not identified differences in allele frequencies or effect sizes in known loci to explain the increased CHD risk in Indian Asians. However, this view is not supported by prospective data. Type-2 diabetes, insulin resistance and related metabolic disturbances are more prevalent amongst Indian Asians than Europeans, and have been proposed as major determinants of higher CHD risk among Indian Asians. Although conventional cardiovascular risk factors contribute to CHD in Indian Asians as in other populations, these do not account for their increased risk. Reasons underlying the increased CHD mortality among Indian Asians remain unknown. CHD deaths on the Indian subcontinent have doubled since 1990, and are predicted to rise a further 50% by 2030. The Indian Asian population accounts for a fifth of all global deaths from coronary heart disease (CHD).

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