The population of the UK includes approximately 1.6 million people of Indian Asian descent, most of whom are first or second generation migrants. In UK Indian Asians, mortality from coronary heart disease (CHD) is 40% higher,1 and admission rates with myocardial infarction are twofold higher,2 compared to the European white population. The increase in CHD risk is most striking in young men, among whom CHD mortality rates are twice those in Europeans.1

The mechanisms underlying increased CHD mortality in UK Indian Asians are not well understood. Population studies show that levels of cigarette smoking, blood pressure, and cholesterol are not consistently raised in Indian Asians, compared to Europeans,3-4indicating that these conventional risk factors do not account for the excess CHD mortality in Indian Asians.3 In contrast, diabetes and insulin resistance are more prevalent in Indian Asians than European whites,3-5 although their precise contribution to increased CHD risk in Asians remains to be determined.