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Homocysteine: a novel risk factor for coronary heart disease in UK Indian Asians
  1. JOHN C CHAMBERS,
  2. JASPAL S KOONER
  1. National Heart and Lung Institute
  2. Imperial College School of Medicine
  3. Hammersmith Hospital
  4. Du Cane Road
  5. London W12 0NN, UK
  6. j.kooner@ic.ac.uk

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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.

Raided plasma homocysteine: an emerging risk factor for vascular disease

Homocysteine is a sulfur containing amino acid, derived from the metabolism of dietary methionine (fig 1).6 Homocysteine concentrations are determined by genetic and nutritional factors; mutations in the genes for enzymes involved in homocysteine metabolism, such as the common 5,10-methylenetetrahydrofolate reductase (MTHFR) 677C→T mutation, and deficiencies of vitamins B6 …

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