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Increased prevalence of coronary heart disease and ischaemic stroke in the Asia-Pacific region

Although hypercholesterolaemia is a well-known risk factor for CVD, the type of lipid profile in South Asians is different compared with other ethnic populations. South Asians have a high triglyceride levels, low highdensity lipoprotein (HDL) levels and increased visceral fat [5,6]. Particle size of lipoproteins seems to be an important predictor of CVD risk. South Asians have comparable levels of low-density lipoprotein (LDL) with other populations but they have smaller LDL particle size [7]. The small particles are more atherogenic in comparison with larger ones because of increased susceptibility to oxidation. Similarly, this population has lower levels of HDL with a higher concentration of less-protective small HDL particles [8]. This pattern of HDL cholesterol was also observed in Asian Indian men with normal HDL values [9]. In South Asian women, level of HDL cholesterol was more important than total cholesterol in determining the CVD risk [10]. High apolipoprotein B100 and apolipoprotein A-I ratio is associated with CVD. In a recent study it was found that the ratio of apolipoprotein B100 to apolipoprotein A-I was 43.8% in native south Asians and 31.8% in individuals from other countries [11]. Thus, levels of HDL, LDL and apolipoproteins play a major role in CVD than total cholesterol in South Asian populations.