2013 Annual Report
South Asian Heart Center
Table of Contents From the Centerâ€™s Leadership Our Accomplishments Heart Attacks: The Hidden Risks Our Strategic Initiatives Our Volunteers Our Philanthropic Partners Financials Message from El Camino Hospital Leadership
3 4 6 7 8 9 10 11
I was 42 when I received a heart transplant. Eighteen years after the transplant, I learned, through the South Asian Heart Center, that I needed to improve on several risk factors. My coach gave me a personal fitness program, a detailed heart healthy diet and a meditation routine to follow. I adhered to the recommendations diligently, and was excited to get outstanding results on my retest. My glucose, and cholesterol numbers were better, and the size of my LDL particles had also improved. I encourage all South Asians to take advantage of this organization that offers an excellent program to mitigate risks associated with heart disease and diabetes. Manmohan S. Mahal Participant & Volunteer, San Jose
South Asian Heart Center 2013 Annual Report
From the Center’s Leadership As the South Asian Heart Center moves into its eighth year, it is getting the recognition it deserves – not only from the people who have benefited from its work, but from the scientific community as well. The highlight of the year for me, was a recent study done in collaboration with the Palo Alto Medical Foundation that validated what we have believed in from the beginning: Education, health coaches, and a culturally tailored approach can reduce the risk factors for cardiovascular disease among South Asians. The study examined traditional risk markers comparing participants at the Center with a matched group of South Asians. Both groups were not on any medication. The participants who had been screened, educated and counseled at the Center showed slightly higher but statistically significant reduction across all markers of cardiovascular risk compared to the control group. We are making a difference. Now, with this science behind our program, we can go out with confidence and rally the community. This Center would not be what it is today without our generous donors, skilled team of professionals, and the amazingly dedicated volunteers and partners.
Ashish Mathur Executive Director South Asian Heart Center
Ashish Mathur The South Asian Heart Center has the most comprehensive assessment and lifestyle risk management tools for South Asians in the United States. We are running the largest prospective research study looking at the dual epidemic of coronary artery disease and diabetes in South Asians. We are happy to see Bay Area physicians connect with and refer their patients to the Center so they may benefit from lifestyle counseling and regular follow-up from the Center’s coaches. This year has been fulfilling as we see that your investment is starting to produce great dividends and facilitate our mission. The Center continues to receive unequivocal support from the leadership at El Camino Hospital and its board of directors. I am thankful to the community for supporting the Center on this exceptional journey. We appreciate your confidence in us and we intend to continue to grow and expand the reach of the Center. Together we save lives, relieve suffering, and create a healthier future for our children and generations to come.
César Molina, MD
Cecile Currier César Molina, MD Medical Director South Asian Heart Center
A bold vision for prevention... India is rapidly becoming the coronary artery disease (CAD) and diabetes mellitus (DM) capital of the world. South Asians (people who trace their ancestry to the countries in the Indian subcontinent) have heart attacks at much younger ages, despite being mostly vegetarian, non-smoking and non-obese. The statistics are staggering. South Asians have at least twice the risk of heart disease, and four times the risk of developing diabetes. An alarming 50% of heart attacks occur before age 55. Family history is a major risk
factor for CAD and DM. What’s more, a diet rich in simple carbohydrates and saturated fat, combined with an increasingly sedentary lifestyle, makes matters worse. The South Asian Heart Center’s AIM to PreventTM program was created expressly to address the unique and unmet needs of the community. Our mission is to reduce the high incidence of CAD and DM by providing culturally tailored, lifestyle-focused, and evidence-based risk reduction techniques to both participants and physicians.
More women die from Coronary Artery Disease than they do of cancer. Yet, a lack of awareness leaves us vulnerable to this epidemic. I proudly support and applaud the efforts of the South Asian Heart Center to raise the awareness of risk, and prevention through simple lifestyle changes.
It has been so rewarding to share our mutual passion and energy to reduce the high disease risk in South Asians. We have been indirectly collaborating in the care of many PAMF patients who have benefited from visiting the South Asian Heart Center. I’m now very excited that PAMF is partnering with the Center to give my patients coordinated care and even more support and lifestyle resources.
Ronesh Sinha, MD
Internal Medicine, Palo Alto Medical Foundation Co-founder of South Asian program (PRANA)
2012 Annual Report
South Asian Heart Center 2013 Annual Report
...reducing risk and saving lives... Our Accomplishments • 4,500 participants screened since 2006; 1,100 retested • 50 events reaching out to 50,000+ community members • 100,000+ unique visitors to website • 17% of participants - made aware of their undiagnosed hypertension • 4% of participants - made aware of their undiagnosed diabetes • 1,000 physicians trained, 300+ collaborating for lifestyle counseling and coaching • Published research in collaboration with PAMF, UCSF and Stanford • Developed “Cooking from the Heart” – an online collection of healthy recipes • Created “Ask the Doctor” newspaper column to enhance community health literacy
Sustained Behavior Change and Risk Reduction 53% participants 31% reached 53%ofof1,780 1,780 participants increased physical activitytarget levels. Increased physical activity levels of 150 mins/week 31% reached target of 150 minutes/week.
37%ofof2,096 2,096 participants increased servings of vegetables. 37% participants 24% reached target 24% reached target of 4 or more servings of of 4vegetables/day. Increased servings of vegetables or more servings of vegetables/day 66%ofof1,107 1,107 retested participants improved 66% retested participants 31% of cholesterol those at riskratios. improved 31% of those at risk improved to optimal levels. Improved cholesterol ratios
to optimal levels
58% of retested participants improved triglyceride levels.
58% of retested participants 40% of those at risk improved 40% of those at risk improved to optimal levels. Improved triglyceride levels
to optimal levels
Heart Attacks: The Hidden Risks Traditional Guidelines
Metabolic panel Total cholesterol (mg/dL)
SOUTH ASIAN HEART CENTER’S
AIM TO PREVENT TM PROGRAM NCEP ATP III Goal
<130; <100|<70 w/CAD*
Triglycerides (mg/dL) TC/HDL ratio Glucose
Anthropometrics Blood pressure BMI
Assess with Advanced Screening
≤26 ; ≤23*
Intervene with Lifestyle MEDS
Meditation – Daily practice of restful alertness Exercise – Regular, vigorous, varied
South Asian Heart Center Advanced Screening
*Optimal (South Asian Heart Center)
Disorders of LDL Cholesterol LDL Small & Medium (nmol/L)
75 / 1420
<80 / <1260
227 / B
>222.5 / Pattern A
LDL Very Small (nmol/L) Apo B (mg/dL) / LDL Particles (nmol/L) LDL Particle Size (Ang) / Phenotype
Reverse Cholesterol Transport HDL Large (nmol/L) Total HDL Particles (nmol/L)
Genetic Predisposition Lp(a) (nmol/L) Family history of CAD / Diabetes
Inflammation CRP (hs) (mg/dL) Predisposition to Diabetes Insulin (μIU/mL) and Dis-metabolism Hemoglobin A1c (%) Homocysteine (μmol/L) Obesity: BMI / Waist circumference (in)
Coronary Artery Disease CT calcium score (%ile)
No / Yes 5.1
8.4 24 / 36
≤26 ; ≤23* / 36
≥4 / ≥2
20 x 2 times
Non-smoker | Quit >2 yrs
Disorders of Lifestyle Sedentary Lifestyle Physical activity (min/week) Malnutrition Vegetable/fruit intake (servings) Stress Levels Rest while asleep (hrs/night)
Rest while awake (meditation,min/day) Smoking Status
Diet – More greens than grains Sleep – Restful, 7-8 hours daily
Manage with Heart-Health Coaching
South Asian Heart Center 2013 Annual Report
Our Strategic Initiatives It is our vision to be the local, national and global leader in preventing cardiovascular disease and diabetes in South Asians and to provide lifestyle-focused, evidence-based risk reduction methodology to the community and physicians. We plan to get there through these following carefully designed strategic initiatives.
Outreach • • • •
Be where South Asians are. Build relationships in the South Asian community to raise awareness of the health disparity. Promote the Center as the “family’s defense to the epidemic”. Seek our participants’ commitment to help those in their sphere of influence enhance lifestyles and reduce risk.
Prevention • • •
Co-locate South Asian Heart Centers in urban areas with large South Asian populations. Develop affordable, minimally invasive, state of the art screening and lifestyle management protocols. Track sustained improvement in lifestyle behaviors and risk reduction in program participants.
Education • • •
Increase the community of trained, collaborating, and referring physicians and health care organizations. Create a formal network of physicians affiliated with the Center. Provide physicians practice guidelines and culturally appropriate resources to address the epidemic.
Research • • •
Publish in peer-reviewed journals risk prediction standards for South Asians. Study the effectiveness of the Center’s AIM to Prevent program. Examine longitudinal impact of lifestyle changes on morbidity and mortality.
Our Volunteers Volunteers are at the heart of all we do. From lifestyle coaching to fundraising, outreach to education, they propel the lifesaving mission of the South Asian Heart Center, expanding our capacity and reach, as we strive toward our vital goals. Here is what some of them have to say about volunteering at the Center.
Nalini Savanur Heart Health Coach (six years)
I have always been interested in health matters. The South Asian Heart Center has given me the opportunity and training to educate, coach, and share my knowledge with community members about heart disease, which is so prevalent in our community. Volunteering as a Heart Health Coach at the Center has been a fulfilling, rewarding, and worthwhile experience. I wish to thank the Center for providing me with invaluable education and training from which my entire family has benefitted.
I am eternally grateful to the South Asian Heart Center for giving me a chance to serve my community. I have now gained valuable exposure to the world of health care and intend to pursue my Master’s degree in this area. I thoroughly enjoyed applying my quantitative skills. I get tremendous motivation and drive from knowing that the participant data I analyzed is extremely relevant and useful in shaping the direction of the program.
Karishma Jadeja Research Intern
Through my work at the South Asian Heart Center, I give back to the community which has served me well. I feel that I make a difference in people’s lives by communicating, coaching, and motivating them on a personal level to make changes in their lifestyles. I feel thrilled and very satisfied when I see my participants follow our rigorous diet, exercise, and stress management recommendations, resulting in reduction in risk of heart disease. As Heart Health Coaches, we each individually manage our cases; but the team is very cohesive and collaborative and coaches are always willing to share lessons learned, success stories, and celebrate participants’ achievements. This environment at the Center, and the love of my work motivate me to continue on as a Heart Health Coach.
Man Singh Man Singh 8
Heart Health Coach (six years)
South Asian Heart Center 2013 Annual Report
...and our Philanthropic Partners President’s Circle $100,000 and above Joy & Dinesh Desai Visionaries Circle $25,000-$99,999 Vibha Apte & Girish Gaitonde Madhu & Navindra Jain Neeraj & Parveen Jain Kalpana & Raj Jaswa Priti & Sanjay Mittal Indira Foundation, Connecticut Ann & Kanwal Rehki Datta & Girish Shah Advocates Circle $5,000-$24,999 Shruti & Rohit Agarwal Nina & R.K. Anand Louanna & Keith Angelo Aparna Balasubramaniam & Manish Balasubramanian Vineeta Bhandari Sabeer Bhatia Sonia & Dr. Puneet K. Chandak Sukanya & K.B. Chandrasekhar Dr. Anu & Murali Chirala Sadhana & Vinod Dham Priya & Murali Dharan Dhanam Foundation Vasu & Anita Ganti Arati & Vishwas Godbole The Prabhu & Poonam Goel Fund
Anuradha & B.V. Jagadeesh Poornima & Arun Kumar Matra Majmundar & Raj Mashruwala Nivedita & Ashish Mathur Nivisha & Manish Mehta Dr. Prasanna & Dr. P.K. Menon Linda & Dr. Cèsar Molina Asha Jadeja & Rajeev Motwani Anjali & Prasad Palkar Pankaj Patel Sharad Patel Vibha & Jayan Ramankutty Sushama & Shyam Rangole Vidhya Ranganathan & Ramani Narayanan Raj-Ann K. Rekhi Rashmi Sinha & Vikram Sahai Ann & George Samenuk Vijay Chawla & Munjal Shah Rita & Vineet Sharma Kalpana Prativadi & P.V. Sridhar Ritu & Poonam Shrivastava Sheetal & Dr. Anil Singhal Chandana Reddy-Sinha & Ranjan Sinha Ramesh Sivakolundu Monal & Vatsal Sonecha Sujatha & Krishnamurthy Suresh Sarah & Prof. Kailath Thomas Jayshree & Vijay Ullal, Sita Foundation Wadhwani Foundation
Friends Circle $1,500-$4,999 Romina & Kulvinder Ahuja Bridgette & Mehmet Akunal Qazi M. Alam Kalpana Trivadi & Rama Aysola Nagaraji Bandaru Prameela & Brian Bartholomeusz Tarun Batra Kobad & Nancy Bugwadia Karishma & Deepak Chandani Asha & Manish Chandra Deepali & Amit Chandra Dave David Diana & Arjun Divecha Shravari Dixit & Yatin Mundkar Lalitha Kumar & Kumar Ganapathy Ewa & Atul Garg Wendy & Robert Gittings Regina P. Gupta Rani Roley & Arvind Jaini Pammi & Vijay Kapoor Anjali Joshi & Sanjay Kasturia Maninder Kaur Bharti & Ashok Killer Renu & Gary Kohli Anuradha & Pritpal Mahal Surendra Mandava Samuel & Shanti Mathan Claire & Gene Miner Bina & Natwarlal Motiram Dr. Harish Murthy Smriti Deokule & Sudip Nag
Smriti Nalawadi Deep Pala Venkat Panchapakesan Shobhana & Bidyut Parruck Mugdha & Sudhir Pendse Geeta Kalia & Ramani Pichumani Sukanya & Puneet Pushkarna Sudha Kidao & Vivek Raghavan Valya & Ramesh Ragu Jaisri Rangan & Venkat Ranganathan M.R. Rangaswami Rohini Rewari Seema & Navin Sahni Anita & Shirish Sathe Cecile S. Currier & Lynn Segal Anuradha & Jay Sethuram Prasad Setty Sanjeev Sardana Sunita & Devang Shah Rajendra & Pallavi Shah Man Mohan Sharma Sanjog Sikand Vishal Sikka Mr. Rajvir Singh Annamma Spudich Shobha Prabakar & Prabakar Sundarrajan Vijay Vachani Mahesh & Sheela Veerina Dr. Akhil Wadhera
Corporate Sponsors $25,000+ El Camino Hospital District Genentech SanDisk Shastha Foods $5,000 – 24,999 Abbott Aetna Foundation AstraZeneca Building Kidz School Cardiovascular Associates Medical Group, Inc. El Camino Hospital Medical Staff Farmers Insurance Headstrong McAfee Pfizer PNG Jewelers SAP-AG St. Jude Medical Takeda Zojio Technologies $2,500 – 4,999 AbbVie, Inc. BAPS Charities, Inc. Biotronic, Inc. Boston Scientific Gilead Sciences, Inc. Google Matching Gifts Heart & Vascular Associates KPMG, LLP Koss Pharmaceuticals Marin General Hospital Medtronic Proactive Foundation Schering Corporation
Includes cumulative donations received through June 30, 2013. The South Asian Heart Center is deeply grateful and appreciates the generosity of all donations, including those below $1500. While we make every effort to recognize the gifts of our supporters, we apologize for any omissions or errors. Please call 650-940-7242 to confirm your donation or to correct any mistakes in this publication.
Financials Fiscal Year 2013 Income El Camino Hospital Community Benefit Individual Giving/Special Events/Grants TOTAL OPERATING INCOME
$ 252,633 $ 315,883 $ 568,516
Expenses Personnel Supplies Fees/Professional and Consulting Services GA/Other TOTAL DIRECT EXPENSES
$ 262,333 $ 27,879 $ 254,080 $ 21,404 $ 565,696
Indirect Expenses TOTAL EXPENSES
$ 6,985 $ 572,681
Expense Allocations 44% El Camino Hospital 56% Gifts/Events/Grants
The South Asian Heart Centerâ€™s fiscal sponsor is El Camino Hospital Foundation, a 501(c)(3) organization, tax-exempt ID 94-2823235
11% Outreach Strategic Initiatives
60% Prevention 8% Education 8% Research Note: 13% G&A/Fundraising
South Asian Heart Center 2013 Annual Report
From El Camino Hospital Leadership El Camino Hospital is proud to have played a fundamental role in making the South Asian Heart Center a reality seven years ago and in continuing to support its efforts to address the high prevalence of heart disease and diabetes in the South Asian community. The most comprehensive program in the country to prevent heart disease and diabetes, the Center has successfully developed and launched a number of unique, culturally appropriate initiatives to raise awareness of and prevent these twin epidemics â€“ through education, advanced risk factor screening programs, and heart health coaching. These combined elements provide a great opportunity for participants to make the most of important lifestyle changes and sustain them over the longterm. Focusing on community education and outreach, the Center continues to make a difference in the lives of patients in our community one heart at a time.
Heart disease and diabetes are among the greatest health crises facing the South Asian community today. The South Asian Heart Center is all about helping individuals of South Asian heritage take control of their lives and make choices to help reduce the risk of these chronic diseases. El Camino Hospital is proud of our partnership with the South Asian community, and we are committed to continuing to support prevention, screening and education to create a healthier community for generations to come. To date, the Center has screened thousands of participants, case-managed several high risk individuals for a year or more, created a Bay Area network of referring physicians, and trained hundreds of physicians on practice methods for early diagnosis, comprehensive evaluation and lifestyle changes. The Center is also observing risk reduction with improvements in triglycerides and lipid levels in case-managed, lifestyle-counseled participants. Together with its research partners, Stanford University and UCSF, the Center has published posters and manuscripts on several topics related to cardiovascular disease and diabetes in South Asians. With all of these successes to date, the Center is well positioned to serve as a model of comprehensive, culturally appropriate care for other communities across the country.
Tomi Ryba President and CEO of El Camino Hospital
Cecile Currier Vice President, Corporate & Community Health Services, El Camino Hospital; Chief Executive Officer, CONCERN: Employee Assistance Program (EAP)