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E-grāmata: Epidemic of Cardiovascular Disease and Diabetes: Explaining the Phenomenon in South Asians Worldwide

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(Bruce and John Usher Chair of Public Health and Honorary Consultant in Public Health Medicine, The University of Edinburgh; and NHS Lothian Health Board)
  • Formāts: 384 pages
  • Izdošanas datums: 07-Feb-2019
  • Izdevniecība: Oxford University Press
  • Valoda: eng
  • ISBN-13: 9780192569943
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Epidemic of Cardiovascular Disease and Diabetes: Explaining the Phenomenon in South Asians WorldwidePalielināt
  • Formāts: 384 pages
  • Izdošanas datums: 07-Feb-2019
  • Izdevniecība: Oxford University Press
  • Valoda: eng
  • ISBN-13: 9780192569943
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In people with South Asian ancestry, the cardiovascular diseases of stroke and coronary heart disease (CVD) are epidemic, and type 2 diabetes mellitus (DM2) is pandemic. As South Asians comprise about 25% of the world's population their high susceptibility is of global public health and clinical importance. Eluding researchers across the globe, this phenomenon continues to be a subject of intensive enquiry.

As Ban Ki-moon, the United Nations Secretary-General, points out, the epidemics of chronic diseases, which he describes as a public health emergency in slow motion, can be restrained but not stopped. With a focus on the global South Asian population, Epidemic of Cardiovascular Disease and Diabetes: Explaining the Phenomenon in South Asians Worldwide is a critical review of current literature investigating the increase in cases of CVD and DM2, and the data underpinning them. The book argues that the high risk of CVD and DM2 in urbanised South Asians is not inevitable, genetic, or programmed in a fixed way. Rather, exposure to risk factors in childhood, adolescence, and most particularly in adulthood, is the key to unravelling its cause.

Drawing on current scientific literature and discussions with 22 international scholars, the book presents a unique synthesis of theory, research, and public health practice under one cover - from tissue research to human intervention trials. It also addresses the challenge many health professionals face in developing countries: to produce focused, low cost and effective actions for combating CVD and DM2. The lessons contained within will have ramifications in healthcare across the globe

Epidemic of Cardiovascular Disease and Diabetes: Explaining the Phenomenon in South Asians Worldwide is ideal for scholars, researchers and health practitioners working towards understanding and preventing the epidemics of these modern chronic diseases across the world.

Recenzijas

This is a commendable book packed with vignettes and a must read for all researchers and epidemiologists pursuing various theories as well as those contemplating research on the topic. * Enas A. Enas MD, FACC, Executive Director, Coronary Artery Disease in Indians (CADI) Research Foundation * This book is a thoughtful and useful addition to my reading list as a teacher of nursing, health care and research. It provides researchers and health-care practitioners with a strong foundation upon which to begin to think about race, ethnicity, multiculturalism and health care. This will be a useful textbook for health-care and research students at the postgraduate level[ .] * Helen Therese Allan, World Health Organisation *

Abbreviations xix
Glossary xxi
1 Introduction to the causes of cardiovascular disease and type 2 diabetes mellitus, South Asians, and the structure and approach of this book
1(37)
1.1
Chapter objectives
1(1)
1.2
Chapter summary
2(1)
1.3 Introduction to the puzzle of South Asians' high susceptibility to CVD and DM2 using an example from Scotland and the aims of this book
3(3)
1.4 South Asians and South Asia: definitions and the issue of heterogeneity
6(2)
1.5 Origins of South Asians and Europeans: implications for genetics
8(1)
1.6 The immensity of the CVD and DM2 epidemic in South Asia: the case of India
9(3)
1.7 Inferring high susceptibility and the emergence of epidemics---the role of reference populations for comparison
12(2)
1.8 A brief introduction to CHD, stroke, and DM2 and especially their known causes
14(7)
1.9 Explanations for the susceptibility of South Asians to CVD and DM2: outline
21(1)
1.10 Data artefact: an improbable explanation
22(2)
1.11 Competing causes: potentially important in examining patterns of death but not usually of morbidity
24(1)
1.12 Health care access: critically important to progression of CVD and DM2 but not to their occurrence
24(1)
1.13 The book's approach to the acquisition and synthesis of evidence: literature review and discussions
25(1)
1.14 The scientific perspective of the book and its author: introducing epidemiology as a clinical, social, environmental, and public health science
26(4)
1.15 Structure of the book
30(8)
2 Genetic explanations 1: the thrifty genotype and its variants
38(20)
2.1
Chapter objectives
38(1)
2.2
Chapter summary
38(1)
2.3 Introduction to genetic hypotheses and to their appeal
39(3)
2.4 A brief introduction to some elements of genetics relating to evolutionary hypotheses for chronic disease in individuals and populations
42(2)
2.5 The thrifty genotype hypothesis
44(4)
2.6 The predation release and drifty genotype hypotheses
48(1)
2.7 The mitochondrial efficiency hypothesis
49(2)
2.8 Conclusions
51(7)
3 Genetic explanations 2: adaptations in body size, shape, and composition
58(17)
3.1
Chapter objectives
58(1)
3.2
Chapter summary
58(1)
3.3 Introduction
59(1)
3.4 The distribution of body fat and why it matters
60(3)
3.5 Explaining South Asians' tendency to high levels of adiposity in general and abdominal obesity in particular
63(2)
3.6 The adipose tissue (compartment) overflow hypothesis
65(2)
3.7 The variable disease selection hypothesis
67(1)
3.8 Fat-free mass and the role of muscle
68(1)
3.9 Other anatomical measures in relation to CVD and DM2
69(1)
3.10 Conclusions
70(5)
4 Genetic explanations 3: neurobehavioural explanations
75(12)
4.1
Chapter objectives
75(1)
4.2
Chapter summary
75(1)
4.3 Introduction to neurobehavioural explanations
76(2)
4.4 Some reflections on the behavioural switch hypothesis
78(1)
4.5 Reflections on the aggression control hypothesis
79(2)
4.6 Further concepts and implications of the neurobehavioural hypotheses of Watve and colleagues
81(1)
4.7 Conclusions
81(6)
5 The thrifty phenotype and related developmental hypotheses
87(35)
5.1
Chapter objectives
87(1)
5.2
Chapter summary
87(1)
5.3 The scope and focus of this chapter
88(1)
5.4 Introduction to the fetal and developmental origins of disease hypotheses
88(2)
5.5 Birth weight, size, and shape: implications for tile thrifty phenotype hypothesis
90(3)
5.6 The thrifty phenotype and maternal investment hypotheses
93(3)
5.7 The DOHAD group of hypotheses specifically in South Asians: an examination of the evidence
96(19)
5.7.1 The focus of the examination
96(1)
5.7.2 The association between birth and post-birth measures and the effect of adjustment for `confounders'
97(9)
5.7.3 Evidence for the DOHAD hypothesis in Indians
106(7)
5.7.4 Evidence for the DOHAD hypothesis in South Asians in the UK
113(2)
5.8 Conclusions
115(7)
6 Socio-economic development and the demographic and epidemiological transitions: effects on psychosocial circumstances and lifestyles
122(17)
6.1
Chapter objectives
122(1)
6.2
Chapter summary
122(1)
6.3 Introduction
123(1)
6.3.1 The demographic and epidemiological transitions
123(1)
6.4 The spread of the epidemic of CVD and DM2 globally: implications for the epidemic in South Asians
124(8)
6.4.1 Psychosocial factors: mental health, stresses of migration, and racism
128(2)
6.4.2 Psychosocial factors in UK South Asians
130(2)
6.5 Poverty as a cause of CVD and DM2, especially in South Asians
132(1)
6.6 The influence of wealth: the example of cooking practices
133(1)
6.7 Conclusions on socio-economic and psychosocial factors
134(5)
7 Established CVD and DM2 risk factors: reappraisal in relation to South Asians
139(1)
7.1
Chapter objectives
139(1)
7.2
Chapter summary
139(1)
7.3 Introduction
140(1)
7.4 High arterial blood pressure
141(4)
7.5 Lipids including LDL-C and Lp(a)
145(4)
7.5.1 Trans fatty acids
148(1)
7.6 Tobacco
149(3)
7.7 Food, diet, and nutrition
152(5)
7.8 Hyperglycaemia and its consequences
157(3)
7.9 Obesity, adiposity, and central adiposity
160(4)
7.10 Physical activity
164(4)
7.11 Salt in the diet
168(1)
7.12 Explaining the susceptibility of South Asians to CVD and DM, using classical risk factors
168(2)
7.13 Conclusions
170(3)
8 Other risk factors and explanations
173(25)
8.1
Chapter objectives
173(1)
8.2
Chapter summary
173(1)
8.3 Introduction
174(1)
8.4 Vitamin D
174(3)
8.5 Vitamin B12, folic acid, and hyperhomocysteinaemia
177(2)
8.6 The pro-inflammatory state
179(1)
8.7 Pro-coagulant state: a tendency to blood clotting (thrombosis)
180(1)
8.8 Infections, microbiota, CVD, and DM2
181(3)
8.9 Renal function
184(1)
8.10 Thyroid dysfunction: an under-investigated postulate
185(1)
8.11 Milk and lactose intolerance
186(2)
8.12 Anatomical and physiological explanations
188(2)
8.13 Miscellaneous risk factors
190(5)
8.13.1 Other co-morbidities
191(1)
8.13.2 Other genetic explanations: non-coding DNA and telomeres
191(1)
8.13.3 Other lifestyles and behaviours
191(1)
8.13.4 Other biochemical disturbances
192(1)
8.13.5 Toxins in soil and food
192(1)
8.13.6 Breast-feeding
192(1)
8.13.7 Cortisol
193(1)
8.13.8 Alcohol
194(1)
8.13.9 Consanguinity, caste, and other forms of inbreeding
194(1)
8.14 Conclusions
195(3)
9 A causal synthesis and models
198(23)
9.1
Chapter objectives
198(1)
9.2
Chapter summary
198(1)
9.3 Introduction: a recapitulation of the main points in
Chapters 1-8, and introduction to the nature of this synthesis and the inclusion of international scholars' perspectives
199(3)
9.4 A simple conceptual causal framework
202(6)
9.5 CVD: fitting the pieces of the puzzle
208(4)
9.6 DM2: fitting the pieces of the puzzle
212(3)
9.7 A summary of causal explanations offered by 22 scholars/researchers
215(4)
9.8 Conclusions
219(2)
10 Implications for health policy, public health, health care, and research
221(26)
10.1
Chapter objectives
221(1)
10.2
Chapter summary
221(1)
10.3 Introduction: approaches to intervention, the state of the art, and the need for a new causal synthesis
222(2)
10.4 Public health policy, public health, health care, and research: principles underlying the current approach
224(2)
10.5 Current approaches and recommendations on the prevention and control of CVD and DM2 in South Asians
226(6)
10.6 Impediments to the implementation of recommendations
232(6)
10.6.1 Lessons from the past for future research on CVD and DM2 in South Asians
234(4)
10.7 Implications of the research synthesis for the recommendations
238(5)
10.7.1 Changeability of risk factors and intermediate outcomes
238(1)
10.7.2 Established risk factors and thresholds
239(1)
10.7.3 The newer ideas needing further exploration: neo-formed contaminants, arterial stiffness, the vasa vasorum microcirculation, and homeostasis/allostasis
240(3)
10.8 Effectiveness and sustainability of interventions in practice: the transferability of knowledge to South Asians
243(1)
10.9 Conclusions
244(3)
Appendix: Discussions with scholars and researchers 247(28)
References 275(60)
Index 335
Raj Bhopal is currently Emeritus Professor of Public Health at The University of Edinburgh.

His books are Concepts of Epidemiology, Epidemic of Cardiovascular Disease and Diabetes; Explaining the Phenomenon in South Asians Worldwide; and Migration, Ethnicity, race and Health. His academic publications include about 350 journal articles, on topics including Legionnaires' disease, primary care epidemiology, environmental epidemiology, ethnicity and health and the pandemic of COVID-19. He is currently focusing on ethnic variations in disease, with a special emphasis on how to respond to this knowledge with more effective public health interventions and clinical services. As Chairman of the Executive Committees he was leader of the first World Congress on Migration, Ethnicity, Race and Health 2018. Raj Bhopal was appointed CBE (Commander of the Most Excellent Order of the British Empire) in 2001.
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