Indians have narrower blood vessels - international expert.

South African Indians (originally migrants from South Asia) have the highest rates of cardiovascular disease and diabetes in the country – and a fascinating contributor may be that their blood vessels are narrower than those of other race groups. Coronary angiograms and postmortem studies reveal this little known fact, according to Dr Alexander T Cohen, honorary consultant vascular physician at Kings College Hospital in London, who cautioned that the high diabetes rates were primarily responsible for the cardiovascular elevation. This emerged in an interview with Cohen who recently completed a lecture tour of South Africa updating doctors, pharmacists and nurses on a groundbreaking new oral therapy for venous thrombo-embolism (VTE). Cohen is also an epidemiologist involved in clinical work, designing, managing and analysing clinical trials from phase 1 to 1V, and both chairs and serves on several international steering committees for multicentre trials, and epidemiological and pharmaco-economic studies. The nugget about lower-calibre blood vessels in Indians emerged when he was asked his opinion on why the highest rates of heart and blood vessel disease in South Africa occur in this community (followed by the coloured community, with the white and black communities having the lowest and most similar rates). He also put the dramatically differing patterns between the white and black local populations (in spite of their having similar rates of disease) down to research skewed by healthcare inequities. Seemingly, the white population predominantly has a pattern of deaths due to heart attacks, while the black population predominantly has a pattern of deaths due to stroke, heart muscle disease and heart disease due to high blood pressure. 'What you may possibly be seeing in some centres in South Africa is that a black person comes with a swollen leg and the doctor is not suspecting venous thrombosis and hence says take an aspirin or anti-inflammatory and they go. This is because the level of clinical suspicion or pretest probability may be low in this racial group. However, this is not borne out by research in African Americans where VTE rates are similar or higher than whites. In contrast, if a white person comes in and is seen in private the clinical suspicion is higher, the threshold for investigation is likely to be lower and hence they get a leg scan and the DVT is diagnosed, or in the case of respiratory symptoms they are sent for a lung scan. ' …