title: Attenuation of microvascular function in those with cardiovascular disease is similar in patients of Indian Asian and European descent.
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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Institute of Biomedical and Clinical Science, Peninsula Medical School (Exeter), University of Exeter, UK. david.strain@pms.ac.uk
authors.forename: William D
authors.initials: WD
authors.lastname: Strain
authors.forename: Alun D
authors.initials: AD
authors.lastname: Hughes
authors.forename: Jamil
authors.initials: J
authors.lastname: Mayet
authors.forename: Andrew R
authors.initials: AR
authors.lastname: Wright
authors.forename: Jaspal
authors.initials: J
authors.lastname: Kooner
authors.forename: Nish
authors.initials: N
authors.lastname: Chaturvedi
authors.forename: Angela C
authors.initials: AC
authors.lastname: Shore
mesh_terms: D000368:Aged; D044466:Asian People / Q000208:ethnology* / Q000235:genetics; D001783:Blood Flow Velocity / Q000502:physiology; D002318:Cardiovascular Diseases / Q000208:ethnology* / Q000235:genetics / Q000503:physiopathology*; D006801:Humans; D007194:India / Q000208:ethnology; D017078:Laser-Doppler Flowmetry / Q000379:methods; D008297:Male; D008833:Microcirculation / Q000502:physiology*; D008875:Middle Aged; D044465:White People / Q000208:ethnology* / Q000235:genetics