Cardiovascular disease is a leading cause of death in the U.S. and the nation spends over $500 billion on cardiovascular disease each year. Studies have shown that immigrants from India, Pakistan, Bangladesh, Sri Lanka and Nepal are experiencing a dramatic rise in heart disease. South Asians make up 25 per cent of the world’s population but they contribute 50 per cent to global cardiovascular deaths.
In this context, as part of an ongoing awareness and education campaign about high risk heart disease in South Asians, American Association of Physicians of Indian Origin (AAPI) the largest ethnic medical organization in the United States presented two eminent speakers and experts, Dr. Enas Enas and Dr. Amit Kera, discussing ways to create awareness on Heart Disease Among South Asians during a webinar on Saturday, October 16th, 2021.
In her welcome address, Dr. Anupama Gotimukula, President of AAPI, said, ” Today is World Restart a Heart Day. Today’s conference is being organized to educate and create awareness about the major health issue faced by South Asians and offer ways to mitigate Heart Disease.” Referring to the American Heart Association, Dr. Gotimukula pointed out that approximately 70 percent of Cardiac arrests occur outside the hospital. “Sudden Cardiac Arrest could be due to multiple reasons. Today’s CME is focused on Recent Advances in South Asian Heart Disease by 2 eminent Indian Americans who are in the forefront of research on this deadly disease.
In his lengthy and detailed presentation with anecdotes from his personal experiences in studying and treating patients with cardio issues, Dr. Enas Enas, provided a broader perspective on the “History and Magnitude of Heart Disease Among South Asians.” Sharing with the audience, how, during his early practice of Medicine, his personal experiences inspired him to get engaged in the research, treatment and prevention, dedicating his life for the cause of heart disease.
Dr. Enas referred to several research/studies around the world, showing high prevalence of CAD among Indians. “Indians have a big problem with premature heart disease,” Dr. Enas said and pointed out that 185,000 people of South Asian origin die of heart disease per year as against 15,000 Whites die of the same health issue. While referring to Mitigating Risk Factors, Dr. Enas recommended Indians to follow the American Heart Association developed Life Simple 7 with additional requirement for exercise and maintaining sugar level below 140.
Dr. Enas Enas, a cardiologist from Chicago and also Director of CADI Coronary artery disease in Indians ) presented a historical perspective as to why the south Asians and especially, Indians have such high risk for heart disease, starting at very young age. Dr. Enas emphasized that traditional factors do not capture the entire risk and suggested that genetics especially LPA plays equally important role and advised all south Asians to get measurement of LP (a) at least once in their life starting at young age.
A true pioneer, Dr. Enas is the first cardiologist to sound the alarm on the strikingly high rates and malignant nature of heart disease among Indians in the US and around the globe Dr. Enas is the first cardiologist to sound the alarm on the epidemic of coronary artery disease among Indians worldwide. As the principal investigator of the landmark CADI Study, he scientifically proved a 3-4 fold high rate of coronary artery disease among immigrants from India to the United States. He is also the first physician to identify and report a genetic predisposition to CAD in Asian Indians, mediated through lipoprotein(a) – a genetic variant of LDL cholesterol.
Dr. Amit Kera, a new rising star in Preventive Cardiology, built on that argument and presented genomic data to fill the gap and also pointed out that usual risk scoring has been done on Caucasians and cannot be extrapolated to south Asians. He advocated for the need for our own data base and especially genomic data to go beyond coronary calcium score and use “ Polygenic score,” which can predict even more accurately the risk of heart disease individually what he calls “Precision Medicine,” a futuristic concept, which he is working on as Associate Director at prestigious Broad institute affiliated with MIT and Harvard. Pointing to international studies that point to prevalence of Cardiovascular diseases high among South Asians, he said, Diabetes is diagnosed four times more among the Asians in comparison with Europeans.
Dr. Khera is a physician-scientist with expertise in epidemiology, clinical medicine, and human genetics. Among his scientific contributions, he developed a new approach to quantify genetic risk for common diseases, as well as the biomarkers that provide new biologic insights, and analyzed large-scale gene sequencing data to highlight key pathways underlying risk for coronary artery disease. His research program uses genetic variation as a tool to uncover new biology and enable enhanced clinical care informed by inherited susceptibility. He serves as the Associate Director, Precision Medicine Unit, Center for Genomic Medicine, MGH; Associate Director, Cardiovascular Disease Initiative, Broad Institute of MIT and Harvard; Instructor of Medicine, Harvard Medical School; and, Cardiologist, Corrigan Minehan Heart Center, MGH.
Dr. Brahma Sharma, Senior Faculty at the University of Pittsburgh affiliated Medical Center, a co-host and moderator of the event, said, “While we are still trying to figure out different mechanisms for this enigma, that should not prevent but rather motivate to follow more aggressively life style modifications and pre-empt and prevent this silent epidemic that is taking a toll on young Indians and South Asians globally.” Dr. Sharma who is serving as the Chair of AAPI South Asian Heart Disease Committee and as the Chair AHA/ AAPI Liaison.
Dr. Amit Chakrbarty, who was a co-host and moderated the discussions, said, “In addition to educational webinars, we also plan to take this knowledge to grass root level via conducting mini- health screening camps across different cities with help of local AAPI chapters throughout USA and invite Global South Asian diaspora to join hands in this mission to prevent heart attacks and save lives.”
In her concluding remarks, urging the need for “Prevention is better than cure,” Dr. Gotimukula said, “Heart disease is the number one Global Public Health problem. South Asians are at a four-times greater risk of heart disease than their western counterparts and have a greater chance of having a heart attack before 50 years of age. Heart attacks strike South Asian Men and Women at younger ages, and as a result, both morbidity and mortality are higher among them compared to any other ethnic group. They tend to develop heart disease ten years earlier than other groups. Efforts to raise awareness of heart disease and promote “Healthy Heart” lifestyles is essential.” For more information on AAPI and its programs, please visit: www.aapiusa.org