Email updates

Keep up to date with the latest news and content from BMC Cardiovascular Disorders and BioMed Central.

Open Access Highly Accessed Research article

Attenuation of microvascular function in those with cardiovascular disease is similar in patients of Indian Asian and European descent

William D Strain1*, Alun D Hughes2, Jamil Mayet2, Andrew R Wright2, Jaspal Kooner2, Nish Chaturvedi2 and Angela C Shore1

Author Affiliations

1 Institute of Biomedical and Clinical Science, Peninsula Medical School (Exeter), University of Exeter, UK

2 International Centre for Circulatory Health, NHLI Division, Faculty of Medicine, Imperial College London & Imperial College Healthcare NHS Trust, UK

For all author emails, please log on.

BMC Cardiovascular Disorders 2010, 10:3  doi:10.1186/1471-2261-10-3

Published: 15 January 2010

Abstract

Background

Indian Asians are at increased risk of cardiovascular death which does not appear to be explained by conventional risk factors. As microvascular disease is also more prevalent in Indian Asians, and as it is thought to play a role in the development of macrovascular disease, we decided to determine whether impaired microcirculation could contribute to this increased cardiovascular risk in Indian Asians.

Methods

Forearm skin laser Doppler fluximetry in response to heating and ischaemia was assessed in 83 Europeans (41 with angiographically confirmed atherosclerotic coronary artery disease (CAD) and 42 from the general population) and 84 Indian Asians (41 with CAD). Explanations for differences in microvascular function were sought using multivariate analysis including conventional cardiovascular risk factors.

Results

Compared to ethnically matched control populations both Europeans and Indian Asians with CAD had poorer microvascular responses to heating than those without (117(95% CI 105-131) vs. 142(130-162) arbitrary units, (au) for Europeans and 111(101-122) vs. 141(131-153)au for Indian Asians) and to ischaemia (44(38-50) vs. 57(49-67)au & 39(34-45) vs. 49(43-56)au respectively). These differences were not accounted for by conventional cardiovascular risk factors. There was no ethnic difference in the attenuation of microvascular function associated with CAD.

Conclusion

Patients of European and Indian Asian descent with symptomatic CAD have poorer microvascular maximal tissue perfusion and reactive hyperaemia in the skin compared to ethnically matched asymptomatic control populations. Despite the increased cardiovascular risk in Indian Asians, the attenuation of microvascular function associated with CAD was equivalent in the ethic groups. This suggests that in Indian Asians microcirculation does not explain the increased susceptibility to CAD.