I'm a 34 year old male, half Indian (South Asian), half Caucasian, who's been working to get healthier. I'm in good health generally, though I am overweight/obese (5'11' and <235 lbs...pants size is 40) and working to slim down and get in better shape, though success has been mixed. I'm also pre-hypertensive but working with my doctor on reducing that along with the weight to try to avoid full blown hypertension. My dad (also Indian) died of a heart attack in his early fifties; my mom (Caucasian) is 67 and doing well. I don't smoke, do drink (but try to keep it in moderation the majority of the time), and have a varied diet, including lots of fruits and veggies. I also take several supplements including a good multivitamin, high dose B Vitamins, extra Vitamin D (based on blood tests), ~2g fish OIL, aged garlic extract, CoQ10, phytosterols, hawthorn, hibiscus, and small amounts of several other compounds such as resveratrol, quercetin, ashwaghanda, reishi/cordycep mushroom, cayenne, etc. I had several questions related to my heritage and heart disease risk.
1.) I recently read that Indians/South Asians have a much higher risk of heart disease than most other races (some say three-fold or higher). Is this true? What effect does mixed (Indian/Caucasian) ethnicity have?
2.) Are there any medical tests more warranted for Indians than other races? For example, I've read things like insulin sensitivity and lipoprotein(a) can be different. Would these, or other tests you might suggest, be worth having based on my genetics?
3.) I do exercise regularly and generally feel good. In an Indian population, are there usually warning signs if you have heart disease (such as erection difficulties, pain when exercising, inability to catch breath, etc.), or is it often silent with heart attack as the first symptom and very little warning preceding it?
4.) A recent study confuses me - please see content.onlinejacc.org/article.aspx?articleid=1205375 - it seemed to indicate aged garlic extract + CoQ10 slowed or reduced atherosclerosis. But it also said that OxPL/apoB and Lp (a) increased significantly. I thought these were bad, but their finding seemed to indicate all benefit, not risk. Thoughts?
5.) Are there any other steps I can take to prevent heart or stroke problems in my future aside from said supplements, exercise, and trying to keep a healthy diet? I guess some of what I read worries me that because of my father's history and some of my genetic predispositions, heart disease is inevitable or I could already have a large degree without knowing it (as I've always been heavy, even as a child).