A new study on people of French Canadian heritage has come to the perplexing conclusion that while French Canadians are more likely to exhibit risk factors for cardiovascular diseases, they nonetheless show no greater prevalence for coronary artery disease (CAD) than non-French white Canadians.

Researchers gathered data on 1683 patients of French Canadian heritage seen at the University of Ottawa Heart Institute between the years 2006 and 2013 and found them more likely than non-French white Canadians to have a history of smoking, diabetes mellitus and a family history of premature coronary artery disease -all risk factors for developing CAD- but when scanned for atherosclerosis, the build-up of plaque within the coronary arteries that signifies CAD, those of French Canadian heritage showed no significant difference from the non-French white Canadians on this key marker.

“Our study suggests that although French Canadians have a greater prevalence of cardiovascular risk factors compared with non-French white Canadians, they do not appear to have a greater prevalence of atherosclerosis as measured by CCTA,” say the study’s authors.

CAD is the result of a narrowing of the coronary arteries, the blood vessels which bring blood and oxygen to the heart. When cholesterol and fat deposits of plaque build up within these arteries, the loss in blood flow can lead to chest pains, shortness of breath and, for some, acute myocardial infarction (AMI) or heart attack.

More than 1.3 million Canadians are living with heart disease. In 2012, more than 66,000 Canadians died from heart disease and according to the Heart & Stroke Foundation, nine in ten Canadians have at least one risk factor for heart disease and stroke. They range from smoking and physical inactivity to high blood pressure, obesity and eating less than five servings of fruit and vegetables a day.

Because French Canadians are known to exhibit multiple risk factors along with having higher rates of heart attack than non-French white Canadians, it has generally been assumed that the incidence of CAD would be higher in this population. The current study goes against that common perception among the Canadian medical community.

One explanation offered by the study’s authors is that French Canadians are exhibiting what is known as the “French paradox,” the well-documented observation that while people in France eat diets of high fat and cholesterol they nonetheless have a low incidence of CAD and relatively low mortality due to cardiovascular disease. According to the World Health Organization, France ranked second only behind South Korea for the lowest rate of coronary heart disease causing death. Canada ranked 27th.

The study’s authors caution that their results are not definitive, meaning that there are likely other contributing factors at play (other than the presence or absence of atherosclerosis) in determining the likelihood of heart disease in the French Canadian population.

“Although our data is to a degree reassuring for French Canadians in our area, targeting this population with higher cardiovascular risk is a reasonable strategy to effect lifestyle change and promote primary prevention to reduce risks of future AMI,” say the study’s authors.

The study was published this month in the Canadian Journal of Cardiology.

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