TY - JOUR
T1 - The Upcoming Epidemic of Heart Failure in South Asia
AU - Martinez-Amezcua, Pablo
AU - Haque, Waqas
AU - Khera, Rohan
AU - Kanaya, Alka M.
AU - Sattar, Naveed
AU - Lam, Carolyn S.P.
AU - Harikrishnan, Sivadasanpillai
AU - Shah, Sanjiv J.
AU - Kandula, Namratha R.
AU - Jose, Powell O.
AU - Narayan, K. M.Venkat
AU - Agyemang, Charles
AU - Misra, Anoop
AU - Jenum, Anne K.
AU - Bilal, Usama
AU - Nasir, Khurram
AU - Cainzos-Achirica, Miguel
N1 - Publisher Copyright:
© 2020 Lippincott Williams and Wilkins. All rights reserved.
PY - 2020/10/1
Y1 - 2020/10/1
N2 - 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.
AB - 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.
KW - South Asian
KW - abdominal obesity
KW - heart disease
KW - heart failure
KW - hypertension
KW - risk factors
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U2 - 10.1161/CIRCHEARTFAILURE.120.007218
DO - 10.1161/CIRCHEARTFAILURE.120.007218
M3 - Review article
C2 - 32962410
AN - SCOPUS:85094221039
SN - 1941-3289
VL - 13
SP - E007218
JO - Circulation: Heart Failure
JF - Circulation: Heart Failure
IS - 10
ER -