Searching for the missing link to heart disease in NZ’s Fijian population

Researchers at the University of Otago, Wellington – Ōtākou Whakaihu Waka, Pōneke, are looking to genetics to understand why Fijian New Zealanders are at higher risk of having heart attacks or developing angina at a young age.

The research is led by Heart Foundation Research Fellow Dr Pritika Narayan from the Department of Surgery and Anaesthesia who says people from Fiji make up almost two per cent of Aotearoa’s population, but experience 20 per cent of the heart attacks or angina in people under the age of 40.

“Some have died in their twenties from undiagnosed cardiac conditions. There is a striking inheritance pattern, with grandparent, child, grandchild affected independent of risk factors such as smoking, obesity and diabetes.
“In one case we know of, a grandfather had a heart attack in his sixties, his son in his forties and his grandson in his twenties.”

The study, funded by the Heart Foundation, is the first in the world to look for a genetic link to premature coronary artery disease among Fijians and Fijian Indians.

Dr Narayan speculates that people with a heightened risk of premature coronary artery disease may have a variation in their genetic code.

“It is possible that variation helped their ancestors survive historical famine events and infectious disease outbreaks but is having the opposite effect now food is relatively abundant, causing fat to accumulate in the arteries and leading to these very premature heart attacks.”

Dr Narayan hopes her research will lead to gene-based improvements in screening, diagnosis and treatment options for Fijian New Zealanders who have a predisposition to developing the disease.

“It will also help Fijian New Zealanders understand their risk of heart disease and give them the chance to access potentially life-saving medicines, such as blood-pressure lowering medicines, or statins to reduce their cholesterol levels, before any damage to their heart occurs.”

Dr Narayan says the genetic research could lead to better care and prevention strategies for other ethnic minority groups who the peoples of Fiji share ancestry with, particularly the 10 million Melanesian people living in the Pacific and the 25 per cent of the world’s population who are South Asian.

She hopes to recruit at least 40 Fijian or Fijian Indian New Zealanders to take part in the study. They will be asked to have a blood test at their nearest Awanui Labs blood collection centre, and scientists will analyse the blood sample so they can study their DNA and RNA and look for biomarkers related to heart health and disease.

To be eligible to take part in the research, participants must have New Zealand citizenship or permanent residency, have Fijian (i-Taukei) or Fijian Indian (Girmit) ancestry and have had their first heart attack, experienced angina, or had related surgery (such as a stent or bypass) before the age of 55. They may also be able to take part if they have a close relative who has had a heart attack at a young age.