Summary: Asian Indians have the highest rates of coronary artery disease (CAD) of any ethnic group studied, despite the fact that nearly half ofthis group are life-long vegetarians. CAD occurs early in age and generally follows a malignant course. Altho~igh the incidence of classic risk factors is low, high triglyceride and low high-density lipoprotein cholesterol levels, high lipoprotein(a) levels, hyperinsulinemia, and apple-type obesity all show a substantial prevalence in this population. Aggressive mtdification of life style beginning before adolescence seemsjustified in view ofthe malignant nature of CAD in this population. Pharmacologic intervention similar to that of secondary prevention of CAD seems justified as primary prevention in high-risk Asian Indians.

No abstract