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New answers to three questions on the epidemic of coronary mortality in south Asians: incidence or case fatality? Biology or environment? Will the next generation be affected?
  1. M Justin Zaman1,
  2. Raj S Bhopal2
  1. 1Department of Cardiology, James Paget University Hospital, Great Yarmouth, Norfolk, UK
  2. 2University of Edinburgh, Edinburgh, UK
  1. Correspondence to Dr M Justin Zaman, Department of Cardiology, James Paget University Hospital, Lowestoft Road, Gorleston-on-Sea, Great Yarmouth, Norfolk NR31 6LA, UK; justin.zaman{at}


Studying ethnic differences in health not only benefits minority groups but is a powerful tool for scientific analysis and for social action in the wider field of health inequalities. Coronary mortality in developed countries is well-known to be higher for men and women born in south Asia compared to other ethnic groups. The aim of this review is to examine how the knowledge of ethnic differences in coronary health in south Asians has advanced in the last decade. We set out to answer the following: Is the high rate of coronary mortality in south Asians a result of high incidence or high case fatality? Why are there ethnic differences, and are they the result of biology, healthcare or social circumstances? Is the cardiovascular health future for south Asians (and especially the UK-born second generation) any brighter than in their parents?

  • Cardiac prevention
  • cardiovascular disease
  • clinical coronary heart disease
  • community cardiology
  • coronary prevention
  • diabetes
  • epidemiology
  • ethnic variations

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  • Competing interests MJZ is deputy chair and RSB is a patron of the South Asian Health Foundation, a UK-based charity.

  • Provenance and peer review Commissioned; internally peer reviewed.