South Asians living with coronary disease experience lower quality of life: study

In a first-of-its-kind study in Canada, Kevin Bainey of the Faculty of Medicine & Dentistry has discovered that South Asians who live in Alberta with coronary disease experience a lower quality of life.

This adds to prior data that this group lives with more severe disease.

Using the APPROACH registry, which captures information about all patients who undergo a coronary angiogram in Alberta, the research team analyzed data about quality of life and health status of this population. The validated survey results showed that South Asians' overall quality of life scored lower. They have more frequent and more severe chest pains, and they aren't able to exert themselves physically as well as Canadians of European descent.

"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," said Bainey. "When diagnosed with coronary disease, South Asians in the community are doing worse and are not satisfied.

"The current data encourages 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 in this population group started when he first became a cardiologist and found out that South Asians - immigrants or their descendants from India, Pakistan, Sri Lanka, Nepal and Bangladesh - who have coronary disease typically present at a younger age, live with more severe disease and have a higher mortality. Bainey says that South Asians make up 17 per cent of the world's population but account for more than 60 per cent of all coronary disease.

"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," said 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's 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 was made aware of South Asians' propensity for heart disease after his heart attack. He says it's vital for people like Bainey to be looking after this group.

"I think he's doing a fantastic job," said Goonewardene. "I think by making people aware and helping them change their lifestyle, their eating habits even before they get these heart attacks, it's a wise thing to do."

Bainey will continue his work in the area. He hopes to get out and help educate this population about their risks of coronary disease. He's also spreading the 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," said Bainey.