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a National Heart and
Lung Institute, Imperial College School of Medicine, Hammersmith
Hospital, Du Cane Road, London W12 0NN, UK, b Department of Cardiology,
Ealing Hospital, Middlesex, UK
Correspondence to: Dr Kooner. email: jkooner{at}rpms.ac.uk
Accepted for publication 25 November 1998
OBJECTIVE
To test the
hypothesis that abnormalities of endothelial function are present in
Indian Asians and may contribute to their increased coronary heart
disease risk.
SETTINGSingle centre
in west London.
PATIENTS26 Indian
Asian and 18 European white healthy male subjects, aged 35 to 61 years
recruited from general practice lists.
DESIGNBrachial artery
diameter responses to reactive hyperaemia and sublingual glyceryl
trinitrate were compared using high resolution ultrasound.
RESULTSMean (SEM)
flow mediated, endothelium dependent dilatation was reduced in Indian
Asians compared with European whites, at 3.2 (0.8)%
v 5.9 (1.0)%, p = 0.03. In contrast,
there were no significant differences in baseline brachial arterial
diameter (4.6 (0.1) v 4.6 (0.1) mm,
p = 0.65) or glyceryl trinitrate induced dilatation (18.8 (1.5)%
v 18.5 (1.7)%, p = 0.90) between Indian Asians and European whites, respectively. Univariate analysis showed
that Indian Asian race was significantly associated with impaired flow
mediated dilatation (regression coefficient = 
2.8 (1.3)%,
p = 0.03), and in multivariate analysis, this relation was
independent of both conventional coronary heart disease risk factors
and markers of insulin resistance.
CONCLUSIONSEndothelial
function is impaired in healthy UK Indian Asians compared with European
whites, and the defect is not accounted for by major coronary heart
disease risk factors. Endothelial function may be modulated by novel
risk factors in Indian Asians.
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