Prevention for South Asian families
Heart disease comes for South Asian families earlier.1
Prevention should start earlier too.
Two to four times the risk. Roughly a decade sooner. And the standard risk calculators were built without a single South Asian in them. Sehat is a cardiovascular prevention program designed around your body, your kitchen, and your family: physician-led, evidence-first.
The burden, stated plainly
A quarter of the world.
Sixty percent of its heart disease.
You already know this in your family. The uncle who had his first stent at 48. The father whose “borderline” numbers stayed borderline until they weren’t. The epidemiology only confirms what South Asian families have watched for two generations, and it says the standard system noticed late.
Read these numbers the right way: they describe the starting line, not the finish line. Risk this concentrated is risk that can be found early, and early is when prevention works best.
of the world’s cardiovascular disease burden, borne by about a quarter of its people
the risk of developing coronary heart disease, compared with people of European descent
earlier onset at the population level, compared with Western populations
of CVD deaths in Asia occur before age 70, versus 23% in the US and 22% in Europe
The instrument
The decade standard care
doesn’t give back.
Two life-lines. One is the timeline the calculators were built on. The other is the one South Asian families actually live. Drag the marker to an age: yours, or your father’s.
At 40, the earlier timeline still has room. This is the age when measuring properly (particles, Lp(a), inflammation, calcium when indicated) changes the most for the least.
Illustrative and educational. The lines are population patterns drawn from the cited epidemiology, not a prediction about any one person. Onset varies; earlier is easier.
The gap
Built from the wrong data,
read with the wrong thresholds.
The standard American equations had no South Asians in them.
The Pooled Cohort Equations were developed and validated in cohorts with zero South Asian representation, then applied to you. Guidelines now name South Asian ancestry a risk-enhancing factor; Sehat starts where that admission leaves off.
BMI was never calibrated for your body.
South Asian risk rises at lower body weights: visceral fat around the organs, at a “normal” BMI. The adjusted thresholds: waist over 90 cm for men, 80 cm for women; overweight from a BMI of 23, not 25.
Lp(a): written in your genes, missing from your panel.
About one in four South Asians carries elevated Lp(a) (≥50 mg/dL). It is almost entirely inherited, untouched by diet, and absent from every routine cholesterol test. One measurement, once in a lifetime, answers it.
The program
Built around your family,
your kitchen, your calendar.
A baseline that finally measures the right things. A plan written for the food you actually cook and the festivals you actually keep. Follow-through that includes the people who set your table.
Lp(a) once, ApoB, particle profile, hs-CRP, advanced metabolic panel, and coronary calcium when it will change the decision.
Meditation, exercise, diet, sleep: the M.E.D.S. framework, adapted to millets and measured tadka, to Ramadan and Diwali, to real households.
Spouses and in-laws are welcome in the room. Prevention in a South Asian family is a household sport.
Radical candor
We publish what
didn’t work, too.
In a 2024 randomized trial, a 16-week culturally tailored community program for U.S. South Asians did not significantly improve blood pressure, cholesterol, or blood sugar at twelve months. The lesson the field drew: cultural tailoring is necessary. It is not sufficient.
Sehat is not a pamphlet in translation. It is measurement, medication when indicated, and follow-through measured in years, with cultural fluency as the delivery system, not the product.
In an observational study of a telehealth prevention pathway, 64.4% of South Asian participants completed the year-long program, versus 39.2% in a historical in-person cohort: design that respects your calendar keeps people in care.
The physician
“As specialists we can often become overly focused on treating someone’s heart, that we forget we are treating someone’s father, grandfather, wife, or little sister. A heart must be treated in the context in which it beats and to whom it belongs.”
Every protocol in Sehat is written (and signed) by a board-certified preventive cardiologist who has spent two decades inside the evidence this community was left out of.
For you, and for them
Start with a conversation.
Bring the family.
Tell us who you are and who you worry about. A physician (not a scheduler, not a bot) reads every inquiry.
References · this page
Every figure, sourced.
- OurHealth Scientific Background. South Asians: nearly a quarter of the world’s inhabitants, ~60% of the global cardiovascular disease burden; two- to four-fold coronary heart disease risk; onset approximately a decade earlier (UCLA Health South Asian Heart Program).
- The Pooled Cohort Equations were developed in cohorts with zero South Asian representation; the 2018 ACC/AHA cholesterol guideline designates South Asian ancestry a risk-enhancing factor.
- Gupta K, et al. JACC Asia, 2022. In 2019, ~39% of CVD deaths in Asia occurred before age 70, versus 23% in the U.S. and 22% in Europe.
- Lp(a): almost entirely genetically determined; absent from standard cholesterol tests; elevated (≥50 mg/dL) in ≈25% of South Asians; a one-time measurement should be considered.
- SAHELI: Kandula NR, et al. JAMA Cardiology, 2024: a 16-week culturally tailored community intervention did not significantly improve measured risk factors at 12 months.
- CardioClick / SSATHI: Kalwani NM, et al. JMIR Cardio, 2021: telehealth pathway completion 64.4% vs 39.2% in a historical in-person cohort (observational).
- Physician voice: “As specialists we can often become overly focused…”: Dr. Tushar Shah, American Heart Association Heart Ball speech, rendered verbatim.
- The Sehat program (baseline panel, adjusted thresholds, and follow-up cadence) is a proposed design under physician supervision; final test selection is an individual clinical decision.