American South Asians need targeted programs to improve heart health, study says

American South Asians – a predominantly immigrant population with heritage from Bangladesh, Bhutan, India, the Maldives, Nepal, Pakistan and/or Sri Lanka – are at greater risk of developing and dying from heart problems than East Asians or non-Hispanic whites people. Pinpointing the underlying causes has proven elusive, prompting scientists at Northwestern Medicine to launch the largest cardiovascular intervention trial for American South Asians.

Although research has attempted to explain the multiple causes for the increased risk of cardiovascular disease (CVD) in South Asians, including risk factors such as type 2 diabetes and lower physical activity, relatively no research has assessed the success of attempts to improve heart health from one of the fastest growing ethnic groups in the US

Scientists at Northwestern University conducted the largest lifestyle intervention study for American South Asians, underscoring the need to build a larger field of research to better represent the diverse and vastly underrepresented group.

The study was published in the news JAMA Cardiology.

To the scientists’ surprise, the 16-week, culturally tailored lifestyle program failed to significantly reduce cardiovascular risk factors, such as blood pressure, cholesterol and blood sugar levels, compared to the control group 12 months after the study began. But from self-reports, study participants said they ate healthier, exercised more and felt more confident about making food and exercise choices, indicating a shift in the right direction.

“This trial marks an important step forward in understanding how we can effectively support South Asian communities in managing their cardiovascular health,” said Dr. Namratha Kandula, principal investigator of the study and professor of medicine at Northwestern University Feinberg School of Medicine.

“Although the results show that our intervention alone was not sufficient to significantly change clinical risk factors, the positive changes in health behavior are promising and pave the way for more refined approaches.”

Kandula, who is also an internal medicine physician at Northwestern Medicine, studies how immigration can impact health disparities and has many affiliations within the university, including the Center for Diabetes and Metabolism, the Institute for Public Health and Medicine’s Center for Community Health and the Robert J. Havey, MD Institute for Global Health’s Center for Global Cardiovascular Health. She said she hopes the paper can be used as a model for others trying to involve diverse populations in clinical research.

The study was tailored to the unique cultural and linguistic needs of the South Asian community. The scientists worked with community partners, including community organizations, schools, public health officials and health coaches fluent in English, Gujarati, Hindi and Urdu, to deliver group sessions in a familiar, accessible environment.

Between March 2018 and January 2022, 549 participants took part in the study and were randomly assigned to a control group, which received information on heart disease prevention every month, or to the lifestyle intervention group, in which participants attended weekly tailored group classes for heart disease prevention. 16 weeks.

Although the trial did not meaningfully change the clinical risk of cardiovascular disease, Kandula said this could be explained by the timing of the coronavirus pandemic, the limited duration of the trial and because many of the health challenges faced by South Asians are related concern the environment and not individual problems. , factors.

“The trial was a way for people in the South Asian community to connect, make friends and gain support for their health behavior change, demonstrating that improving heart health goes beyond the individual level, and that people need to be part of something bigger.” to maintain motivation and support,” Kandula said.