Fwd: Reissue: South Asian American Health Conference: Medical Recomme ndations

[biren_saraiya]

A detailed summary of the meeting from SAPHA (South Asian Public
Health Association email group).

biren

--- In sa...@yahoogroups.com, "Ghosh, Chandak (HRSA)" <cghosh@h...> wrote:
Just made some corrections to the date and location:


The 1st South Asian American Health Conference was held June 3, 2005 in
North Brunswick, New Jersey.

Attended by over 200 people, the conference was hosted by UMDNJ and
co-sponsored by such groups as SAPHA, the South Asian Health Project,
AAPI,
APPNA, among others.

It was an extraordinary day with sessions about demography, cardiovascular
disease, diabetes, cancer, mental health, domestic violence, oral health,
infectious disease, diet/nutrition, and the politics of healthcare.


IN ORDER TO KEEP THIS SUMMARY SHORT AND READABLE, I'VE ONLY INCLUDED THE
INFORMATION AND RECOMMENDATIONS CONCERNING CARDIOVASCULAR DISEASE AND
DIABETES, THE TWO BIGGEST KILLERS OF SOUTH ASIAN AMERICANS


Much of the discussion was around the latest research into how
diabetes and
cardiovascular disease affects South Asians Ameri
cans (SAAs) more severely
that the average American.

Here are the highlights and recommendations made by a panel of experts:


Diabetes and Cardiovascular Disease:

1) Diabetes rates in the US are highest in Pima Indians, followed by
Mainland Puerto Ricans, South Asians, and Mexicans, respectively.

2) At current rate, 90% of SAAs will be diagnosed with
hypertension and
50 to 60% with diabetes in their lifetimes.

3) SAAs are diagnosed with diabetes about 10 years earlier than the
average American.

4) SAAs are predisposed to insulin resistance. Obesity, especially
abdominal obesity (to which SAAs are also predisposed), is associated with
decreased effect of insulin. Since the body starts producing more
insulin in
response, its effects are also pronounced: higher lipid levels, lower HDL
(good cholesterol), higher LDL (bad cholesterol), platelet aggregation,
vessel wall inflammation--> All leading to cardiovascular disease, the
number one killer of SAAs.

5) Average age for heart attacks in SAA is 52 years as compared to
white Americans at 63 years.

6) Identifying Patients at Risk: "Metabolic Syndrome"

Metabolic Syndrome is a set of physical conditions which signify increased
risk for Coronary artery disease, congestive heart failure, diabetes,
heart
attack, and stoke.

For average Americans, Metabolic Syndrome is defined as having three
of the
following five conditions:

a) Blood Pressure >130/85
b) Fasting blood sugar >110 mg/dl
c) Fasting Triglyceride > 150 mg/dl
d) HDL level <40 for men & <50 for women
e) Increased waist to hip ratio (waist >40 in. for men and > 35 for
women)

For South Asian Americans, however, Metabolic Syndrome definition must be
changed to --waist-to-hip ratio numbers 4 inches less (>36 for men and >31
for women), and Blood Pressure >130/80.

50% SAAs have Metabolic Syndrome compared to 25% of other Americans.

7) "Overweight" for average American is considered a Body Mass Index
(BMI) of > 25.
For SAAs, "overweight" is BMI>23


GENERAL MEDICAL RECOMMENDATIONS FOR SAAs:
(Other than the well-known, but mostly ignored, eat better and exercise)

A. Yearly, starting at age 20, SAAs should get tested for a fasting
blood sugar and lipid panel to look for diabetes and cholesterol levels.
B. Stress testing to measure heart health should start at age 40.
C. Consider taking aspirin (81 mg-baby aspirin) every day to prevent
heart disease starting at age 30. The very real side effect of
bleeding is
minimized by taking this low dose.
D. Because of high risk, SAAs should have cholesterol goals of: LDL
between 70 and 100, Triglyceride < 150 and HDL >45.






Sincerely yours,

Chandak Ghosh, MD, MPH
Medical Consultant
DHHS/Health Resources and Services Administration (HRSA)
New York Regional Office
26 Federal Plaza, 3337
New York, New York 10278
Phone: (212) 264-2545
Fax: (212) 264-2673
Email: CGhosh@H...
--- End forwarded message ---