Abstract 16217: Culturally-tailored Team-based Preventive Cardiology Program Improves Cardiovascular Risk for South Asian Patients

• Published in: Circulation (New York, N.Y.) Vol. 142; no. Suppl_3 Suppl 3; p. A16217
• Main Authors: Pearson, Keon, Parameswaran, Vijaya, Gibbs-Curtis, Destini, Johnson, Austin, Josan, Kiranbir, Rodriguez, Fatima, DASH, Rajesh
• Format: Journal Article
• Language: English
• Published: by the American College of Cardiology Foundation and the American Heart Association, Inc 17.11.2020
• ISSN: 0009-7322; 1524-4539
• DOI: 10.1161/circ.142.suppl_3.16217

IntroductionSouth Asians (SA) have a two times greater prevalence of CAD and metabolic syndrome (MetS) than matched Europeans. Diet and physical activity may be best addressed through culturally-tailored interventions. The Stanford South Asian Translational Heart Initiative (SSATHI) was designed to help SA better understand and improve their risk factors. We tested the hypothesis that a team-based and culturally-tailored clinical intervention for SA would result in a reduction in MetS risk factors.MethodsPatients underwent an initial assessment consisting of fasting lipid profile, advanced lipid studies (lipid fractionation, lp (a), apoA1, apoB), inflammatory markers (high sensitivity CRP, homocysteine), and A1c. All non-diabetics underwent two-hour OGTT. Following initial assessment by a cardiologist, a registered dietician developed a personalized nutrition plan based on SA cuisine.ResultsA total of 395 patients were seen between July, 2011 and July, 2019. Of these, 198 (50%) completed at least two cardiologist visits with baseline and follow up labs. Patients had an average age of 45.5 years and 86% were male. At baseline, SSATHI patients had a mean BMI of 26.4 (IQR = 23.9-28.8), 52% of patients had total cholesterol greater than 190 mg/dl, 21% had systolic BP > 140 mmHg, and 13% had diastolic BP > 90 mmHg. During an average follow-up of 11.8 ± 9.2 months, diastolic BP declined from 80.9 ± 9.32 to 78.9 ± 7.6 mmHg (p = 0.028), total cholesterol decreased from 190.4 ± 46.4 to 153.4 ± 63.7 mg/dl (p < 0.001), total triglycerides declined from 137.1 ± 87.1 to 100.2 ± 67.5 mg/dl (p < 0.001), and LDL declined from 120.4 ± 40.0 to 92.3 ± 46.4 mg/dl (p <0.001). HDL declined from 49.0 ± 15.4 to 44.5 ± 19.8 mg/dl (p = 0.022). ASCVD and A1c were not significantly different.ConclusionA team-based and culturally-informed program targeted to South Asian populations may help improve cardiometabolic risk factors but may be limited by program attrition and generalizability.