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• Heart Disease and South Asians 50 years later: a time for change
  Vivian S Rambihar
  Published on: 29 January 2010

• Published on: 29 January 2010

  Heart Disease and South Asians 50 years later: a time for change

  • Vivian S Rambihar, Cardiologist
  • Other Contributors:
    • Sherryn Rambihar, cardiology felllow, McMaster University and Vanessa Rambihar, medical student, U Toronto

  Chen and Whitlock mention differences in risk for heart disease among South Asians, Chinese and others, in seeking to unveil the causes of heart disease in China, regionally and globally (1). Continuing disparities and high rates of diabetes and premature heart disease continue among the 25 million South Asians abroad and the 1.3 billion in South Asia, with initial low rates in China and the Chinese diaspora now increasing...

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  Chen and Whitlock mention differences in risk for heart disease among South Asians, Chinese and others, in seeking to unveil the causes of heart disease in China, regionally and globally (1). Continuing disparities and high rates of diabetes and premature heart disease continue among the 25 million South Asians abroad and the 1.3 billion in South Asia, with initial low rates in China and the Chinese diaspora now increasing.

  The first research submitted showing differences in heart disease between South Asians and Chinese was to this journal (then the British Heart Journal) in February 1959 by Muir, published January 1960, exactly fifty years ago (2). This necropsy study showed disproportionate early mortality in South Asians in a study of seven racial groups in Singapore from 1948 to 1957 (2). The first research published was by Danaraj and co- authors, submitted April 1959 and published October 1959 in the American Heart Journal, from similar necropsy studies in Singapore from 1950 to 1954, showing similar results, and reprinted January 2010 with an accompanying editorial (3,4).

  Credit for first publication and citations have gone to Danaraj, who became an esteemed physician and leader in Malaya. Muir, with scant reference to his publication in the extensive literature on this subject, became an acclaimed leader in cancer research in Scotland and globally.

  Time to publication was longer for Muir, likely since the British Heart Journal was a quarterly then and the American Heart Journal, monthly, explaining earlier submission and later publication. The lack of credit and citations likely stems from the inadvertent omission of Muir's publication from the 131 references in the 1989 definitive review, and a typo in the text mentioning the first publication by Danaraj as 1957 rather than October 1959, making Muir's in January 1960, seem much later.

  The 50th Anniversary of Muir's neglected landmark publication in this journal is an opportunity to correct this, to recognize Muir's and Danaraj's equally pioneering research on disparities in health, and an opportunity to review and reduce continuing disparities (4). With the causes of heart disease mostly unveiled, we now have a golden opportunity to change the course of heart disease for South Asians and for all communities globally (4).

  1. Chen Z, Whitlock G. Unveiling the causes of heart disease in China. Ed. Heart 2009;95:1818-9.

  2. Muir CS. Coronary Heart Disease in seven racial groups in Singapore. British Heart Journal 1960;22:45-53

  3. Danaraj TJ, Acker MS, Danaraj W, et al. Ethnic Group Differences in Coronary Heart Disease in Singapore: An Analysis of Necropsy Records. American Heart Journal 1959;58:516-26.

  4. Rambihar VS, Rambihar SP, Rambihar VS Jr. Race, Ethnicity and Heart Disease: a challenge for cardiology for the 21st century. Ed. Am Heart J 2010; 159:1-14.

  Conflict of Interest:

  None declared

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  Conflict of Interest:
  None declared.

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