Heart Health among Indians in the Diaspora

By Dr. Kumar Mahabir & Shalima Mohammed, MBP

Indians in the Girmit-[indentured]-descended diaspora experience disproportionately high rates of heart disease, often at younger ages, driven by a complex mix of genetic predisposition, migration-related lifestyle changes, stress and dietary transitions. This program explored genetics as well as culturally specific risk factors such as central obesity, diabetes, physical inactivity and high-carbohydrate diets, while highlighting prevention strategies rooted in traditional foods, community support and early screening. Our aim was to empower individuals and families to protect their heart health without losing the richness of their cultural heritage.

The following are excerpts from an Indo-Caribbean Cultural Centre (ICC) Thought Leaders’ Forum (04/01/2026). The Zoom program was chaired by Shalima Mohammed from Trinidad and moderated by Dr. Seshni Moodliar Rensburg from England/South Africa. There were (4) speakers in the program. The topic was “Heart Health among Indians in the Diaspora” See the unedited recording of the program: https://www.youtube.com/@dmahab/streams

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Dr. Pritika Narayan of New Zealand, originally from Fiji A Girmit-descendant, who leads the Fiji Heart Study, a world-first genomic project said:

“The Fiji Heart Study asks why so many young Fijians in their 20s-40s suffer premature heart attacks despite being otherwise healthy and slim. These individuals often develop aggressive plaque buildup and severe coronary artery disease, with patterns seen across multiple generations, suggesting a strong genetic driver. Although Fijians are only 2% of New Zealand’s population, they account for 20% of premature  Coronary Artery Disease (CAD) cases. We believe this elevated risk may be linked to the extreme environmental pressures and historical famine endured by our ancestors, highlighting how past events continue to shape heart health today.”

Dr. Vijay Kapadia is an interventional cardiologist based in Australia but originally from Fiji. He led the creation of the first tertiary cardiac unit in the South Pacific in Suva the capital of Fiji said:

“While CAD is a major issue in the Girmitya population, the problem is broader and affects the South Asian diaspora worldwide. Premature CAD, vascular disease, and early mortality are increasingly observed among people of South Asian origin across the globe. From my experience as a junior doctor in Suva, Fiji, it was common to see young Indian patients in their 20s and 30s experiencing heart attacks. Many were not obese, diabetic, or smokers, suggesting factors beyond standard risk profiles. The susceptibility of people of Indian origin to CAD has long been noted. Early studies, including necropsy work in Singapore, showed a disproportionate number of Indians with coronary disease, indicating that this population has been affected by CAD for generations.”

Dr. Mahendra Carpen of Guyana, an interventional cardiologist and cardiac electrophysiologist, said:

“When I first returned to Guyana in 2012, most heart attack patients were in their 50s and 60s. Over the past decade, that age has dropped to the 30s and 40s, showing a worrying trend toward earlier heart disease. Many people think ‘a small heart attack’ is not a big deal, but it is actually an important warning of underlying cardiovascular problems. Even if heart function seems normal at the time, the risk of deterioration is real. Heart attack symptoms can differ between men and women. Men often have central chest pain, while women may present with dizziness or discomfort between the shoulder blades. Universal screening including symptom checks, physical exams, basic measurements, blood tests, ECGs, stress tests, echocardiograms, and coronary evaluation by age 45 or earlier, for high-risk individuals can make a real difference. Heart disease in Guyana, particularly among people of Indian descent, is among the highest in the Americas, causing significant death and disability. While risk factors are the same as globally, they are appearing at younger ages. Aggressive screening and early intervention are urgently needed to prevent further premature disease.”

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Dr. Vivian Rambihar, born and raised in Guyana, and later migrated to Canada, is now a Toronto cardiologist who has been advocating for the prevention of heart disease and diabetes in the Indian diaspora for decades, said:

“Indians are spread all over the world from India to Fiji with both similarities and differences in food, culture, and geography etc. We must recognize the tremendous health and wellness that exists within India and the diaspora with even a man running a marathon at age 100. At the same time, we have to recognize, raise awareness, work harder and start earlier to prevent and treat the excess and premature heart disease and diabetes all across the diaspora. This requires figuring out why it happens, and attention from all across society, addressing social, cultural, political, commercial and other determinants, in addition to health. Especially in those with many risks and early family history, we have to identify the disease early with tests and treat more intensely. We should tap into the strong community networks to help each other and help create a culture of health across the diaspora and reduce this high risk.”

(Dr. Kumar Mahabir is an anthropologist, editor, and publisher based in Trinidad and Tobago. He is an Assistant Professor at the University of Trinidad and Tobago (UTT) and Chairman of the Indo-Caribbean Cultural Centre Co. Ltd.)

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