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A ssathi (partner) to thwart heart disease in South Asians

S.S., a 44-year-old male South Asian engineer, visited Rajesh Dash, MD, PhD, at his Stanford clinic not long ago.

"He had come to see me almost as a third option," Dash told a crowd of 25-or-so listeners at a presentation on South Asians and heart disease sponsored by the Stanford Health Library last week. Dash didn't mention why S.S. originally visited a doctor. But he said S.S. exercised three times a week and ate relatively healthy food. He smoked socially. His blood pressure was only slightly elevated. He didn't appear to be at high risk for heart disease.

One doctor had left S.S. with little more information than he had before the visit after the results of a standard diagnostic questionnaire were inconclusive. Another doctor recommended an angiogram. S.S. balked - why, he asked.

So he came to see Dash, who directs SSATHI, or the Stanford South Asian Translational Heart Initiative, a clinical program that specializes in coronary disease and insulin resistance in South Asians, which is defined to include people from India, Pakistan, Bangladesh, Nepal, Bhutan, Maldives and Sri Lanka.

Dash asked S.S. a question no one else had: What about your family? "Well," S.S. responded, "my older brother, who is 46, had a heart attack recently. My mother has four stents in her arteries. Three of my mother's brothers died of heart attacks before they were 60."

Now, no medical degree was needed to see that S.S. was clearly at high risk for heart disease. Dash prescribed a coronary CT scan that revealed that one of S.S.'s heart vessels was 99 percent blocked. In other words, S.S. was a walking time bomb. Doctors treated his condition aggressively with a combination of drugs, surgery, recommended lifestyle changes and follow-up care.

S.S. had three questions for Dash: Why did this happen to me? How can I prevent it from happening again? And, how can I prevent it from happening to my children?

Dash doesn't have the answers to all the questions — yet. But his SSATHI team (Ssathi also means companion or partner in Hindi) is working to figure them out - and to keep S.S. healthy for decades to come. The team surrounds patients with experts — cardiologists, nutritionists, surgeons and others. And they provide social-media tools and encourage around-the-clock commitments from patients. The program is no cake walk.

Dash also shared some startling statistics: More than half of all South Asians who suffer heart attacks get them before age 50. In California, South Asians have four times more heart attacks than other ethnic groups. South Asians also have a high rate of diabetes and heart disease is now the top cause of death in India, Dash said.

Ssathi hopes to treat South Asians of all ages, but they're particularly looking for new patients from ages 20 to 55 because heart disease in South Asians begins at young ages. The SSATHI program is focusing South Asians in California, but Dash said they also plan to introduce programs in India.

Previously: Global community must do a better job of managing risk of Nipah virus, expert says, A closer look Asian American health and Gap exists in women's knowledge of heart disease
Image by geralt

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