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Asian Indian heart health is at risk

Did you know that the leading causes of death in Asian-Indian immigrants in the United States are cardiovascular disease (CVD) and cancer? CVD includes heart disease and strokes, and accounts for almost 26% of deaths for Asian-Indian immigrants (and 27% of deaths in India). Asian-Indian immigrants have higher rates of CVD, diabetes, and metabolic syndrome compared to the general US population and other immigrant groups.

A recent study concluded that risk in the Asian-Indian population of developing coronary heart disease that is 3‐ to 4‐times higher than that for white Americans. Data also show that heart disease occurs in Asian Indians five to ten years earlier than other ethnicities.  A National Institutes of Health publication suggests that ‘cultural beliefs, societal obligations, and gender roles within the South-Asian community are indirect contributors to the health of South-Asian immigrants.’

If you’re an Asian-Indian immigrant like me, this should make you sit up and pay attention.

Understanding risk factors

Medical Centers across the U.S. have been paying attention and responding.  The South Asian Heart Center was established in 2006 at the El Camino Hospital in Mountain View, CA, to respond to this incidence of heart disease in the urban South-Asian population. The Center’s AIM to Prevent program is designed to reduce the incidence of heart disease and diabetes in South Asians through early diagnosis, individually-tailored programs and community education. 

Nearby, Stanford Health Care has a similar research and treatment program called the Stanford South Asian Translational Heart Initiative, or Ssathi, to help South Asians better understand their risk factors and provide targeted treatment plans for patients.

Key contributors to poor heart health

One key contributor to CVD is hypertension or high blood pressure. Left uncontrolled, hypertension can damage the arteries, heart, and brain. It harms arterial inner-lining cells, making artery walls less elastic, and limiting blood flow throughout the body. It can also cause an aneurysm or enlargement of a section of the artery wall, which can rupture and cause life-threatening internal bleeding.

Coronary artery disease results from poor blood flow to the heart through damaged arteries, leading to angina, arrhythmias, or heart attacks. An enlarged left ventricle (the lower left heart chamber) can occur, leading to heart failure or sudden cardiac arrest. Hypertension can also lead to transient ischemic attacks (TIAs), and strokes resulting from blood clots that block blood flow to the brain. Other health issues such as vascular dementia, mild cognitive impairment, and damage to the kidneys or eyes can also result from damaged blood vessels caused by hypertension.

Making lifestyle changes

We can make lifestyle changes to maintain or improve our heart health. These include diet, exercise, stress control, and eliminating smoking.  There is a lot to know and learn about these interventions. This article addresses one important aspect of our daily diets that impacts heart health: our consumption of sodium and potassium. Magnesium and calcium also play important roles in controlling our blood pressure, heart, and brain health.

These four minerals in the form of electrolytes play a crucial role in the function of the muscular tissue of the heart known as the myocardium. Especially important for the normal contraction of skeletal and cardiac muscle fibers, they help create the tiny forces that result in muscle contraction. An imbalance of these electrolytes can have detrimental effects on the heart, causing or contributing to arrhythmia and cardiac arrest.

What works – potassium & sodium

A detailed explanation of the impact of the imbalance is beyond the scope of this article. Potassium and sodium work together to maintain fluid and blood volume and help our bodies function normally. Increasing potassium intake reduces blood pressure and increasing sodium intake raises it. Studies show that a high sodium/potassium ratio is a stronger indicator of increased risk of cardiovascular disease than levels of either sodium or potassium alone. When the sodium-potassium balance is disturbed, heart contractions can become abnormal, increasing the risk of heart ailments and heart attacks. 

Too much sodium in the bloodstream pulls water into the vessels, increasing the volume of blood flowing through them. That can lead to high blood pressure and an increased risk of heart attack and stroke. Potassium helps lower blood pressure by lessening the effects of sodium. Low levels of potassium, known as hypokalemia can cause irregular contractions and abnormal electrocardiograms, among other problems.

Calcium deposits cause plaque

Calcium deposits are part of artery-clogging plaque; they also contribute to the stiffening of the arteries and interfere with the action of heart valves. Some physicians recommend against taking calcium supplements unless indicated in individual cases.  Magnesium is necessary for the proper function of the heart. Adequate levels decrease the risk of heart disease, heart attack, and dangerous heart rhythms (arrhythmia). Magnesium helps boost ‘good’ HDL cholesterol levels, relaxes the walls of the blood vessels, and helps keep blood pressure down. It also plays a key role in regulating electrochemical processes, and vascular tone and calcification. All these minerals play other key roles in our bodies that are not discussed here.

The 2015-2020 Dietary Guidelines for Americans advise adults to consume less than 2,300 milligrams of sodium per day. The American Heart Association sets an ideal limit of 1,500 mg per day. Dieticians recommend reading nutrition labels carefully. Processed foods are the highest contributors to sodium intake.

Daily dose of goodness

An average adult should get 4,700 mg of potassium daily.  Sources of Potassium include vegetables and fruit, including bananas, sweet potatoes, spinach, peas, and tomatoes. Fat-free milk and yogurt help. A medium banana, for instance, has about 420 mg. of potassium, while a cup of cooked lentils has 730 mg. Dairy, beans, lentils, and many seeds are good sources of calcium. Nuts and seeds – peanuts, sunflower seeds, pumpkin seeds – are also good sources of Magnesium.

What should you do about all this?  First, see your physician for a complete checkup. If you have any risk factors, or if you have a family history of CVD, consult a specialist. Develop a targeted plan for lifestyle changes that include diet, exercise, and stress-reduction components. Become an educated consumer. Take active control of your heart health, while continuing to enjoy the foods you like!

Photo by Boxed Water Is Better on Unsplash

Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within the South Asian community. Sukham provides curated information and resources on health and well-being, aging, and life’s transitions, including serious illness, palliative and hospice care, death and bereavement. Contact the author at

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Mukund Acharya

Mukund Acharya is a regular columnist for India Currents. He is also President and a co-founder of Sukham, an all-volunteer non-profit organization in the Bay Area that advocates for healthy aging within...