The South Asian Heart Center was created by El Camino Hospital in 2006, as an independent non-profit, to expressly meet the unique and unmet needs of the South Asian community. Its mission is to reduce the high incidence of coronary artery disease (CAD) and diabetes mellitus (DM) by providing culturally tailored, lifestyle-focused, and evidence-based risk reduction techniques and tools to South Asians and their physicians. The Center raises awareness, prevents disease through screening, counseling, and coaching participants, educates and partners with physicians, and collaborates on research to address these health disparities.
El Camino Hospital is a non-profit hospital, committed to community health issues. In the mid 2000s, the hospital found that South Asians were just 3% of the population base it served, yet, they constituted a much larger portion (5-6%) of admissions to the Emergency Room. This was a matter of community health, and true to its mission, the hospital generously supported a group of South Asian physicians and philanthropists start an initiative aimed at addressing chronic diseases unique to South Asians. The South Asian Heart Center has already served as a model for the design of tailored solutions to healthcare issues for other ethnic minorities.
South Asians are people who trace their ancestry to the countries in the Indian subcontinent like India, Pakistan, Bangadesh, Sri Lanka, and Nepal.
Currently the South Asian Heart Center operates from the headquarters in El Camino Hospital, Mountain View, an office in Los Gatos and a weekly clinic in Milpitas. Additional locations are planned in 2015, for other Bay Area cities with large Asian Indian populations, like San Jose and Fremont.
Mountain View Location:
El Camino Hospital
Willow Pavillion, 2nd Floor
2480 Grant Road,
Mountain View, CA-94040
Los Gatos Location:
777 Knowles Drive, #17A
Los Gatos, CA-95032
Coronary Artery Disease (CAD) and Diabetes Mellitus (DM) are global epidemics among people of South Asian descent. These chronic diseases strike South Asians at a younger age, and more severely than the general population. This, despite many being lifelong vegetarians who do not smoke and are not overweight.
Coronary artery disease (CAD) also known as atherosclerotic heart disease, atherosclerotic cardiovascular disease, coronary heart disease, or ischemic heart disease (IHD), is the most common type of heart disease and cause of heart attacks. The disease is caused by plaque building up along the inner walls of the arteries of the heart, which narrows the arteries and reduces blood flow to the heart.
Diabetes mellitus (DM), also known as simply diabetes, is a group of metabolic diseases that result in high blood sugar levels over a prolonged period. This high blood sugar produces the symptoms of frequent urination, increased thirst, and increased hunger. Untreated, diabetes can cause many complications. Serious long-term complications include heart disease, stroke, kidney failure, foot ulcers and damage to the eyes. Diabetes is due to either the pancreas not producing enough insulin, or the cells of the body not responding properly to the insulin produced.
Higher incidence of CAD and DM
Indians bear 60% of the world’s heart disease burden despite being only 17% of the world's population. Indians and other South Asians experience heart disease at rates at least two times higher, and diabetes at four times higher rates than any other nationality or ethnic group. Globally, 10-12% of the South Asian population in urban areas and 4-6% in rural areas is afflicted with heart disease.
CAD is not just a disease for South Asian men
South Asian women also have one of the highest mortality rates due to CAD. Findings from the 1990-2000 California Census data showed that all ethnic minority women, except South Asian women, were living longer.
Traditional risk factors fail to fully explain the increased and early presentation of heart attacks in South Asians. South Asians don't have a higher incidence of obesity or high blood pressure. They don't usually smoke. Nearly half are lifelong vegetarians. But there are some genetic and lifestyle-related risk factors that come into play. Indians suffer from diabetes and poor cholesterol ratios at a younger age. Their laboratory results often demonstrate higher levels of emerging risk factors such as: elevated atherogenic small dense lipoprotein particles (LDL), reduced large protective high density lipoprotein (HDL) particles, higher Lipoprotein(a), inflammatory markers and insulin and glucose abnormalities. The traditional Indian or desi diet is deficient in vegetables and high in simple carbohydrates, added sugars, salt, and saturated fats.Modern life tends to be high-stress, and many South Asians don't make time for regular exercise, adequate rest, and stress reduction. Genetics set the stage for heart disease in Indians, but it is lifestyle that brings the curtain down on far too many people, far too young.
Yes, you may be at risk and should be concerned. If you are South Asian man or woman between 18-60 years of age, you will benefit from the Center’s AIM to Prevent program. Additionally, if you have high blood pressure, diabetes, an abnormal cholesterol profile, or a family history of these conditions, heart disease, or stroke, then you may be at greater risk of having an event such as a heart attack, an abnormal stress test, or a non-zero calcium score on the CT scan.
The South Asian Heart Center is El Camino Hospital’s response to a health crisis unique to the South Asian population. South Asians trace their origins to the countries of India, Pakistan, Sri Lanka, Bangladesh and Nepal. This epidemic impacts a significant 10-12% of the urban South Asian population worldwide. The Center’s program of early evaluation with advanced screening for heart disease, and prevention through lifestyle modification, is currently available to participants of South Asian descent only. The Center will however provide information on advanced screening to other populations (non-South Asian) and have them connect with their primary care physician to determine their need for special evaluation and further treatment as required.
Cholesterol by itself is not a good predictor of heart attacks. 80% of heart attack patients have normal cholesterol levels as measured by a traditional lipid panel. A better indicator is the ratio between LDL, or the "bad" cholesterol and HDL, the "good" cholesterol. LDL carries the cholesterol into the arterial wall, while HDL pulls it out of your arteries and delivers it back to the liver for disposal. Often, normal or borderline cholesterol values mask the underlying disease, and you may need additional tests to expose your true risk profile.
At the South Asian Heart Center, we perform a comprehensive advanced lipid panel to look at cholesterol and other markers in a more detailed, granular way. For example, we determine the size and number of your lipoprotein particles, a better gauge of risk for atherosclerosis. We assess other factors, not typically evaluated which may increase your risk, such as your genetic predisposition, level of inflammation, other metabolic and lifestyle disorders.
Family history is very important. For instance, your level of Lipoprotein(a) or Lp(a), and the size and pattern of LDL cholesterol particles are genetically determined. Plus, your own risk of heart attack is doubled if your father had a heart attack before the age of 55, or your mother, before the age of 65.
Studying the medical histories of your parents and siblings can help us predict your risk for heart attack and diabetes. Diabetes is an epidemic among South Asians. By 2030, Indians will bear 50% of the global burden of diabetes. In fact, here at the Center, 50% of our participants report a family history of diabetes, placing them at a higher risk for both diabetes and coronary heart disease. Even though there may be a genetic predisposition for these chronic conditions, there is mounting evidence that this increased risk can be successfully mitigated by lifestyle interventions.
Heart attacks happen when blood flow to a part of the heart is totally obstructed. There are different causes of a heart attack, also known as a myocardial infarction or MI. The most common cause of a heart attack is coronary atherosclerosis; or the buildup of plaque due to inflammation in the arterial wall. This can be caused by high blood pressure, diabetes, tobacco use, abnormal cholesterol, or genetic predisposition. A healthy artery has endothelial cells that produce substances that keep blood from clotting. Plaque disrupts these cells and causes them to fail. At the same time, the plaque narrows the arteries so that less blood can get through. This is a recipe for clot formation. When a clot does form, it slows and eventually stops the flow of blood to the heart, causing the heart attack. The longer the heart is deprived of blood, and therefore, oxygen, the greater the chance of damage to the heart muscle.
A much less common cause of heart attack is a coronary artery spasm, which refers to a sudden, severe constriction of a coronary artery that blocks blood flow. This can happen even in an artery that has no plaque buildup. Cigarette smoking, exposure to extreme cold, emotional stress and street drugs such as cocaine and methamphetamines can all lead to this type of heart attack.
An ounce of prevention is worth a pound of cure. According to a recent World Health Organization study, 80 percent of heart attacks are preventable with the right lifestyle modifications. Coronary artery disease is a disease of lifestyle and can be managed, and even reversed, if there is a commitment to a good, regular daily routine. Unfortunately many people don't know they're at risk until it's too late. Or, they're misinformed and think that after starting medications, having a bypass operation, or a stent implanted, they are out of danger. Unfortunately, this is not true. Medical interventions like medication, bypass surgery, or stent placement are not guaranteed to prevent further damage to the arterial wall. Better outcomes are likely for those who commit to a good, all inclusive medical regimen, with special attention to a healthy, regular routine.
The need to take medication to help prevent a first heart attack depends on the severity of your risk factors, your capacity to modify them with lifestyle and the presence or absence of atherosclerosis. Medications are mandatory for individuals with known coronary artery disease and they enhance the benefits of a healthy lifestyle program. Statins, aspirin and beta blockers are the most commonly prescribed medications for patients at risk. Statins lower cholesterol levels in the blood and they are of benefit even if your cholesterol level is normal, while beta blockers help prevent angina, treat high blood pressure, and enhance longevity. Your physician may advise you to take aspirin regularly to inhibit clot formation. Both statins and aspirin independently have been shown to prevent heart attack in about 30 percent of patients at risk. Medications are an important aspect of prevention but they do not take away the need for a healthy, regular routine.
Chest discomfort or pain: This discomfort or pain can feel like a tight ache, pressure, fullness or squeezing in your chest lasting more than a few minutes. This discomfort may come and go.
Upper body pain: Pain or discomfort may spread beyond your chest to your shoulders, arms, back, neck, teeth or jaw. You may have upper body pain with no chest discomfort.
Stomach pain: Pain may extend downward into your abdominal area and may feel like heartburn.
Shortness of breath: You may pant for breath or try to take in deep breaths. This often occurs before you develop chest discomfort, or you may not experience any chest discomfort.
Anxiety: You may feel a sense of doom or feel as if you're having a panic attack for no apparent reason.
Lightheadedness: In addition to chest pressure, you may feel dizzy or feel like you might pass out.
Sweating: You may suddenly break into a sweat with cold, clammy skin.
Nausea and vomiting: You may feel sick to your stomach or vomit.
Most heart attacks begin with subtle symptoms — with only discomfort that often is not described as pain. The chest discomfort may come and go. Don't be tempted to downplay your symptoms or brush them off as indigestion or anxiety.
Women may have all, none, many or a few of the typical heart attack symptoms. While some type of pain, pressure or discomfort in the chest is still a common symptom of a heart attack in women, many women have heart attack symptoms without chest pain, such as:
The elderly and diabetics may have no or very mild symptoms of a heart attack, so it's especially important not to dismiss heart attack symptoms in people with diabetes and older adults even if they don't seem serious.
Quick action can save your life: Call 9–1–1.
Heart attack symptoms vary widely. For instance, you may have only minor chest discomfort while someone else has excruciating pain. The signs and symptoms of a heart attack can develop suddenly. However, they also can develop slowly—sometimes within hours, days, or weeks of a heart attack.
Any time you think you might be having heart attack symptoms or a heart attack, don't ignore it or feel embarrassed to call for help. Call 9–1–1 for emergency medical care, even if you are not sure whether you're having a heart attack. Here's why:
Every minute matters. Never delay calling 9–1–1, or to take aspirin. Don't "tough out" heart attack symptoms for more than five minutes. Call 911 or other emergency medical services for help. If you don't have access to emergency medical services, have someone drive you to the nearest hospital. Drive yourself only as a last resort, if there are absolutely no other options.
You may be at risk for a heart attack despite showing no recognizable symptoms. When symptoms appear, it may already be too late. Screening is the first step in preventing chronic disease. Screening also identifies potential risk, not typically detected at an annual physical.
Being young is not cardio protective enough for South Asians, as is demonstrated in several studies in global urban and rural South Asian populations. 25% of heart attacks occur in those younger than 40 years, and 50% in those less than 55 years. By comparison, the typical age for the first heart attack in the general population is 65 years for men, and 70 years for women. Early detection is critical to prevention. The Center starts screening South Asians from the age of 18.
Being pre-menopausal is not sufficiently cardioprotective for South Asian women who have one of the highest mortality rates due to CAD. Findings from the 1990-2000 California Census data showed that all ethnic minority women other than those of South Asian descent, were living longer. Since prevention is better than cure, young South Asian women should identify their risks by signing up for advanced screening. Also, as their family’s health officers, women should be leaders and embrace prevention; the rest of their family is bound to follow and benefit from adopting healthier lifestyles.
Maybe so. But ignorance is not bliss, and you should do it for the sake of your children. Knowing your risk factors and managing them with lifestyle and other interventions could result in better quality of life and longevity.
AIM to Prevent is a specialized program for a special population. This unique program is an evidence-based, culturally tailored, lifestyle-focused program designed to prevent heart disease and diabetes in South Asians. The program comprises of three phase – Assess, Intervene, and Manage.
All phases of the AIM to Prevent program are uniquely focused on disease prevention in South Asians. Unlike typical tests done at the doctor’s office, the advanced screening is more comprehensive and includes measurement of emerging, genetic, metabolic, inflammatory and lifestyle disorders, as well as traditional markers. Expert counseling is focused entirely on proven lifestyle interventions. Finally, the program offers ongoing, personalized coaching, not typically available at doctors’ offices. AIM to Prevent is a high value program, delivered affordably, to a vulnerable population.
It has been shown through research conducted at the Center, that compared to routine care, AIM to Prevent provides a statistically significant reduction in risk, across all traditional markers. Participants who have retested with the Center have seen improvement in risk factors such as cholesterol ratio and triglycerides. They have also improved lifestyle behaviors with increased vegetable consumption and physical activity.
If you are a South Asian man or woman over 18 years of age, you can sign up online. This program is currently available to South Asians residing in the United States. Once you sign up, the Center will follow up with you to schedule your appointments.
The first phase, Assess, will typically take 3-4 weeks once you schedule and follow-through on your appointments and ends when you review your assessment and recommendations plan with the health educator. The second phase Intervene, includes a series of counseling and orientation sessions on Lifestyle MEDS (Meditation, Exercise, Diet, and Sleep), our lifestyle intervention model, and is typically completed within 2 weeks. In the third phase, Manage, you will be assigned a heart health coach who will monitor your progress for one-full year with regular monthly touch-points, and annually thereafter. AIM to Prevent is a program for life and what you learn as a participant can be practiced life long.
The traditional lipid profile is a blood test to measure lipids or fats/fatty substances that serve as energy sources in the body. Lipids include cholesterol, low density lipoprotein or LDL, high density lipoprotein or HDL, and triglycerides. However, conventional screening underestimates your true risk for CAD. The Center’s advanced tests better predict risk by assessing factors such as lipoprotein particle composition, genetic predisposition, presence of inflammation, metabolic abnormalities, and lifestyle disorders, in addition to the conventional factors. The advanced tests and the corresponding CPT codes are as follows:
AIM to Prevent was designed to provide a high value but affordable program for all South Asians to utilize and derive benefit. Click here for details on cost and your out-of-pocket expenses.
The list price for the advanced laboratory tests is approximately $1000, but is covered by most insurance companies who are in network with Quest Diagnostics. Click here for details on cost and your out-of-pocket expenses.
If your insurance company is not in-network, or you decide to self-pay, your cost for the advanced tests is $125, and the processing fee of $49 is waived.
The test results from your annual physical contain the evaluation of the basic lipid panel, and do not include the additional markers that better predict your risk of heart disease and diabetes. The value of the AIM to Prevent program is to evaluate and educate participants on their hidden risks, revealed in the routine annual physical, and to personalize recommendations on lifestyle, based on the comprehensive set of markers.
A typical annual physical includes tests for your overall health, one of which is the traditional lipid panel which may underestimate your risk. Most South Asians would benefit from a more comprehensive evaluation like the South Asian Heart Center’s AIM to Prevent program, to assess and address specifically, their risk of heart disease and diabetes. Our program complements the medical management provided by your physician, with expert counseling and personalized coaching on therapeutic lifestyle changes that lead to reduction in risk. In fact, the three way partnership between you, your physician and the Center is a big win-win for you.
Since the advanced tests are typically not part of the standard guidelines, most physicians do not routinely order these tests. In addition, physicians bound by the managed care policies and guidelines of their medical group affiliation are unable to order these tests. However, if your physician agrees, we can provide a list of the CPT codes for each of the laboratory tests in our advanced screening. Your final out-of-pocket cost will remain the same whether your physician or the Center enters the lab order in the Quest diagnostics system.
If you choose to get these tests done with your physician, you will need to provide the results to us so we may proceed with the remainder of your AIM to Prevent program.
The goal of our specialized program is to help you lower your risk of heart attack through a full evaluation of your risk factors, followed by lifestyle interventions and coaching. This philosophy is based on evidence from studies that have shown the positive impact of modifying diet, increasing physical activity, quitting tobacco, getting enough sleep and managing stress. A recent study demonstrated that after only four years of improving your regular routine, you can reduce the incidence of heart attack by 35%, and enhance your longevity by 40%. Additionally, people who have elevated blood sugars and are at risk for diabetes can decrease their risk by 58 percent within 2.8 years by incorporating exercise and modest changes in their diet. A recent study of first-time heart attack patients found that dietary changes can reduce the rate of recurrence by up to 70 percent.
As a participant in the AIM to Prevent program, you can choose to work with a heart health coach. Your coach will guide you through the lifestyle changes recommended by our clinician for a whole year. Lifestyle changes are hard to make and maintain. The Centers’ coaches use their culturally sensitive training to monitor your progress and motivate you to stay on track. Research has shown that heart health coaching makes a difference.
The $49 processing fee, and the out-of-pocket expenses associated with the advanced test are FSA/HSA reimbursable. If your FSA/HSA is set up for automatic deduction, it may be easier to go the self-pay route, pay the $125 flat rate (reimbursable), and avoid any surprises in the amount deducted.
If you are self-insured, and are utilizing your insurance company to cover the advance test, depending on your insurance company actuarial policies, your results may be factored in the renewal premium calculation. If you self-pay for your advanced tests, no insurance company is involved. The impact of the results of the advanced test on your insurance premiums will be no different if you underwent the advanced test at your physician’s office or at the South Asian Heart Center.
The Center may recommend a retest to determine and review if the lifestyle interventions (and medications, if so prescribed by your physician) after the baseline test, have had any effect on your risk profile. For most at-risk participants, the Center recommends consulting with their physician, and based on their profile, repeat the test in 3, 6, or 12 months. After the first year, the Center recommends the normal retesting as directed, and at the physician’s office on a regular basis, and an advanced test once a year with the Center.
The epidemic of heart disease and diabetes in South Asians calls for drastic intervention. Physicians refer their South Asian patients to the Center to benefit from the Center’s AIM to Prevent program’s lifestyle focus that is complementary to the medical management their patient receives from them. The synergistic partnership with the Center results in improved outcomes for their patients.
No, that is not something we will do. We believe in a win-win-win partnership between your patient, you and the Center. We share all your patient’s advanced screening results and the Center’s recommendations and our intervention plan with you. Moreover, the Center encourages your patient to set up an appointment with you to discuss our report, review our suggestions for medications as warranted, and seek prescriptions as well as further work-up as you feel necessary for ongoing disease management.
Some of the benefits include:
The South Asian Heart Center currently partners with the Palo Alto Medical Foundation, American Association of Physicians of Indian Origin and CAMSF (Cardiology Associates of Marin and San Francisco) medical groups in addition to hundreds of individual medical practitioners.
The Center welcomes physicians and researchers to collaborate on pertinent questions regarding the epidemic, better prediction and tracking methodologies, impact of lifestyle and other interventions on disease prevention and reversal, and longitudinal analysis on longevity, successful aging, and mortality. Please submit your research topic interests, specific research questions and aims, and your background and resume to firstname.lastname@example.org. You will hear back, as appropriate.
You can choose to volunteer in any of the following areas:
For most volunteer positions, time commitment is a minimum of 10-12 hours a week. Heart health coaches need to definitely commit to a minimum of 10 hours per week. High school volunteers typically come in twice a week after school and put in 3-4 hours each week. 4-6 hour commitments are okay for office volunteers.
We recommend our volunteers be 15 or older.
Yes you can. At events which are typically held on weekends.
It depends on the role that is taken on. For example a heart health coach, office work or help with front desk will have to come to the center to volunteer.
The Center does not provide recommendation letters for all its volunteers on a routine basis. However, the Center is delighted to answer job verification inquiries and provide recommendation letters for college applications on the basis of merit, to qualified volunteers who have provided at least six months of continuous service.
The process after signing up includes an HR background check and a health evaluation for all positions requiring working at the Centers' locations. Typical lead times from initiation of application to start of work is approximately 2-3 weeks. Click here to start sign up process.
The El Camino Healthcare District provides 50% of the South Asian Heart Center’s budget. The district has committed $1,950,000 over the next three years to support our ongoing efforts in Mountain View and Milpitas, and growth into new areas. Grants and participant fees are expected to provide an additional $300,000. The remainder of $2,100,000 must come from leadership donations, the annual Scarlet Night gala and participant fees. El Camino Hospital provides office space and infrastructure as well as marketing and fundraising support.
The Center’s nominal participant fees are not sufficient to cover the full cost of the Aim to Prevent™ program. However, we believe higher fees would create a barrier that prevents people who are unaware of their high risk factors from getting screened. Donations and gala proceeds are vital to make up the balance of the 50% of the South Asian Heart Center’s budget that is not covered by El Camino Hospital and the Healthcare District.
A non-profit, the South Asian Heart Center will always rely on donor support to sustain its operations so we can maximize the number of South Asians we serve. We plan to increase the sustainability of donor support by encouraging past donors and new participants to contribute on a yearly basis through an e-newsletter and regular direct mail appeals. We are also inaugurating a Pay it Forward program that honors our donors while reminding participants that their screenings were underwritten through the generosity of others, and asking them to reciprocate by making their own gift to ensure more people can benefit.
Includes cumulative donations received through June 30, 2013
The South Asian Heart Center’s Advisory Council members are drawn from the South Asian community of philanthropists, business professionals, and community leaders. See current members
Yes, all donations to the South Asian Heart Center are tax-deductible to the full extent of the law. The South Asian Heart Center’s fiscal sponsor is El Camino Hospital Foundation, tax-exempt identification number: 94-2823235.
Donate online or send a check, made out to El Camino Hospital Foundation, to 2500 Grant Road PAR116, Mountain View, CA 94040. Please note in the memo line that the gift is for the South Asian Heart Center. If you have any questions, please call 650-940-7154 and ask for Philanthropy Officer Nivisha Mehta.
By requesting your company to match your contribution, you multiply the impact of your gift. Please check with your Human Resources Department. Each company has its own policy and process.
Yes, you may designate your gift to any of the following:
Lifestyle Score is a tool developed by the South Asian Heart Center with the sole purpose of providing you with a qualitative assessment of your lifestyle habits and a quick look at the discrepancy if any, between your perception and our assessment. For a true picture of your risk of heart disease and diabetes, we recommend that you sign up for AIM to Prevent.
Lifestyle Score is a tool intended for qualitative assessment of your lifestyle habits. It is not a diagnostic or screening tool. You can sign up for our comprehensive AIM to Prevent program to get a complete evaluation of risk factors for heart disease and diabetes, and additionally talk to your physician about any questions you have about your risk of chronic disease.