S Asian Heart Centre in Silicon Valley

South Asian Heart Centre will provide information about treatments specific to South Asians, writes Shalini Narang.

To raise awareness on the issue of high prevalence of coronary artery disease (CAD) in South Asians, El Camino Hospital in Mountain View will open this fall at South Asian Heart Centre. The first one of its kind in United States, the centre will provide information about treatments specific to South Asians and aims to bridge cultural gaps between South Asian patients and mainstream health providers.

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The initiative for the centre was taken in a joint meeting of several South Asian physicians of the various hospitals in the Bay Area, prominent community leaders and the hospital staff.

"The centre will develop strategies to address conventional and non conventional cardiovascular risk factors that affect South Asian patients and will develop culturally relevant exercise plans, including meditation and yoga classes." Says Jon Friedenberg, Vice President of Resource Development and President of the El Camino Hospital Foundation.

Many physicians are not familiar with the risk factors unique to South Asian patients because most cardiovascular disease research has been conducted on the mainstream community. For example, while many South Asians are vegetarians, many traditional South Asian foods are fried and cooked in other unhealthy ways like the excessive use of clarified butter (ghee) in the diet that can contribute to higher risk of the heart disease. Health experts say that physicians who are aware of such cultural differences in diet and other factors will be able to devise more effective treatment plans.

In June, the centre received its first $1 million donation from Malini Alles, founder of an organisation named Stree: Global Investments in Women.

The South Asian Heart Centre will have a wellness program to educate clients and physicians on the latest research, tests and treatments unique to the South Asian community.

The body of knowledge on CAD among South Asians draws largely from the pioneering research of Dr Enas Enas, Director of the Coronary Artery Disease among Asian Indians (CADI) Research Foundation in University of Chicago, and a member of the South Asian Heart Centre's advisory board. According to Enas, "The South Asian Heart Centre at El Camino Hospital in Silicon Valley will be the first organization in the world to address this critical problem. This centre will demonstrate the importance of early screening and prevention education to avoid cardiac catastrophes, and its impact will be felt in countries around the globe."

Initially, the South Asian Heart Centre will provide cardiac screenings for the identified risk factors in addition to prevention education and referrals to wellness providers. The centre's education program will also inform the medical community about the need for adopting cardiac screening guidelines tailored to South Asians with the goal to have doctors prescribe, and insurers cover, routine tests of South Asian patients at a younger age for the specific predictors of heart disease among this population.

Besides the common risk factors, research has shown that there are other risk factors for CAD in South Asians including increased prevalence of glucose intolerance, higher total and LDL cholesterol, higher triglycerides, and lower HDL (good cholesterol), higher concentrations of fibrinogen, homocysteine, lipoprotein (a), and plasminogen activator inhibitor-1. Genetic susceptibility in South Asians further aggravates the adverse effects of conventional risk factors related to adverse lifestyle choices such as smoking, high blood pressure, high cholesterol, and diabetes.

Although the conventional risk factors do not fully explain the excess burden of CAD, these risk factors are doubly important in South Asians and remain the principal targets for prevention and treatment. Early adoption of daily exercise and avoiding tobacco use is crucial. Watching the saturated fat intake and waist size is as, if not more, important than watching cholesterol intake and body weight. A waist circumference of greater than 80 centimetres (32 inches) in women and more than 90 centimetres (36 inches) in men are a powerful predictor of future development of diabetes and CAD. All conventional and non-conventional risk factors warrant a need for a regular exercise regimen and cutting down on calories.