Asian immigrants to the United Kingdom and elsewhere are at greater risk of mortality and morbidity from coronary heart disease (CHD) than UK whites. This predisposition has yet to be explained. More than 63,000 Asian people, a high proportion of whom are under 40, live in Leicester. Projections of the local Asian and non-Asian populations indicate that numbers of Asian people in higher-risk age groups will more than double between 1988 and 2008. In the absence of effective intervention, numbers of CHD deaths among Asian people, and the prevalence of other manifestations of CHD in this group, will rise by an equivalent amount. This predicted shift in the ethnic distribution of CHD has important implications for the planning of acute services in Leicester. Our predictions also demonstrate both a valuable opportunity and a pressing need for local research into the aetiology of CHD among Asian people, upon which preventative strategies may be based.