RICADIA = Risk Intervention in Coronary Artery Disease in Indian Americans Project.
A tax exempt, not for profit organization established in January 2003.
Public Charity Tax Exempt 501 (c) (3) Not for Profit FEIN # 02-0535718 Organization # 2401978
Welcome to RICADIA.ORG, a tax exempt not for profit organization dedicated to research in Coronary Artery Disease (CAD) in general and heart disease in Asian Indian Americans in particular. RICADIA is committed to conduct and promote clinical, basic science and genetics research into Coronary Artery Disease and to raise global awareness of heart disease through community programs, to help screening individuals and families and offer advice with therapeutic life style changes, pharmacological intervention and regular follow up. Please read below and click on 'Patient Education' above and read about Asian Indian Studies and RICADIA project
Since its inception in 2003, RICADIA has conducted the NAIHDP(National Asian Indian Heart Disease Project) Impaired Reverse Cholesterol Transport in Asian Indians in collaboration with Dr.Robert Superko at the Berkeley heart lab and the DIA(Diabetes in Indian Americans)study in collaboration with AAPI with five research sites in the USA and two sites in India.Diabetes and Heart Disease in Indians Please find these studies and Annual Updates on heart disease published in AAPI convention souvenirs and India Abroad, India Post and Indus Business Journal by clicking on the 'Patient Education' link above and 'Asian Indian Studies'.
RICADIA is collaborating with the Department of Genetics at the University of Southern California to conduct genetics studies in Indians. Please click on Genetics Study in Asian Indians USC-RICADIA for more information; and the San Diego State University to study the prevalence of metabolic syndrome and cardiovascular risk in college youth of multiethnic descent.
Dr. Purushotham Kotha who envisioned and established the RICADIA is the Director of the project.
The following are the academic advisers for RICADIA project:
Sunder Mudaliar. M.D Diabetes and Metabolism
Associate Professor of Medicine University of California San Diego
Ranjita Mishra. PhD Associate Professor of Health and Kinesiology, Texas A & M University
Vibha Bhatnagar. M.D, MPH Assistant Professor of Medicine University of California San Diego
Pragna Patel. PhD. Professor of Genetics University of Southern California
Please read thru' brief description of heart disease in Indians to follow and Asian Indian studies in 'Patient Education' and additional information on our home page.
Please call (619) 229 1995 or email any questions to director@ricadia.org or
pkotha@heartsmart.info.
RICADIA = Risk Intervention in Coronary Artery Disease in Indian Americans Project:
Asian Indians have the highest incidence of Metabolic Syndrome, Diabetes and Heart Disease among all ethnic groups living on this Globe! Asian Indian population living in the United States of America comprises of people from India, Sri Lanka, Pakistan and Bangladesh. Observational studies over last fifty years from Singapore, United Kingdom and many other countries all around the world have shown that Asian Indians not only have a very high incidence of heart disease but they are also affected by it at a much younger age. Men and women, vegetarians and non vegetarians and smokers and non smokers are all affected by heart disease. Heart disease is declining in the Western population where is it is rising on an epidemic scale in Indians living in the U.S and the Indian Sub-Continent. Asian Indians have a very high incidence of metabolic syndrome, pre-diabetes and diabetes which predispose them to heart disease. Sedentary life style, unhealthy culinary practices and nutrition are the environmental factors that trigger the genes responsible for heart disease, heart attacks and sudden cardiac death. The following question and answer format is intended to help you to learn about heart disease in Indians and how to prevent it.
What is Coronary Artery Disease (CAD)?
CAD is a condition in which fatty deposits (plaque) accumulate in the lining of the Coronary Arteries (atherosclerosis), which supply blood to the heart. This results in narrowing of the lumen and obstruction of blood flow.
For the heart to contract and pump blood normally, a continuous supply of oxygen and nutrients rich blood flow from Coronary Arteries to the heart is required. As the obstruction in the Coronary Arteries advances, there is inadequate blood flow to the heart leading to chest pain (angina) and heart attack (myocardial infarction), heart failure and premature death. Many times an early, not so severe or soft plaque ruptures obstructing the blood flow completely and causing a heart attack. Therefore it is important to prevent plaque build up at the earliest possible.
What is Premature Coronary Artery disease?
CAD occurring before age 65 in women and age 55 in men. CAD occurring before age 40 is usually very severe and causes massive heart attack and/or sudden cardiac death (Malignant CAD).
What are the reasons to start the RICADIA project?
Asian Indians have the highest risk of CAD and it also starts at an early age.
Hospitalization rate of CAD among Asian Indians in US is four times higher than Caucasians, Japanese and Filipinos and five times higher than Chinese.
Asian Indian women are also at high risk of CAD and its complications.
Earliest identification & aggressive treatment of CAD is very important to prevent morbidity & mortality that results from this number one killer disease.
The guidelines developed by the N.C.E.P-National cholesterol education program are based on the results of long term studies in U.S population and do not address the risk factors and life styles unique to Asian Indians. Therefore many Indian patients will go unrecognized and untreated. RICADIA Project is designed to address these problems specific to Asian Indians and provide them with specific guidelines and therapeutic life habits customized to each individual to achieve timely and maximum prevention of heart disease.
What are the risk factors for CAD in general?
High cholesterol
Smoking
High blood pressure
Diabetes
Family history of CAD
Male gender
Menopause (Change of life) in women.
What risk factors for CAD are common in Asian Indians?
Why life long vegetarians have to worry about heart disease.
Their risk is identical to that of a non-vegetarian.
What is Lp(a)?
When present in excess quantities in blood it favors premature fatty deposition (Atherosclerosis), and blood clotting in the blood vessels (thrombosis), it is also responsible for the high failure rate of balloon angioplasty and coronary artery bypass surgery. More than 90% of Lp(a) is genetically determined and adult levels are reached by the first year of life. If either of the parents has a high level of Lp(a), there is a strong probability of their children developing premature CAD because their Lp(a) levels are identical to that of their parents. Therefore these children should be screened and prevention offered at the earliest age possible to halt the progress and change the natural course of CAD in them.
What is Metabolic (central obesity-insulin resistance) syndrome?
Type 1 Diabetics have high blood sugar and insufficient or lack of insulin and require insulin injections to sustain life. People with Insulin Resistance and Type 2 Diabetes have high blood sugars and higher than normal but ineffective insulin levels and larger waist line. There is a high prevalence of this syndrome in Asian Indians and it contributes to other metabolic and lipid abnormalities and heart disease.
What is primary prevention and what is secondary prevention?
Primary prevention is to identify individuals at risk for CAD at an early stage before symptoms and signs of CAD appear and provide them with specific diet, life style, and pharmacological advice as indicated by their test results. Secondary prevention is for patients who already have symptoms and signs of CAD. These are angina (chest pain), Myocardial Infarction (heart attack), heart failure, dysrhythmias (heart rhythm disturbances) and cardiac disability. Besides diet and life style advice these patients are provided with pharmacological treatment with the following medications, interventions and devices as indicated.
Statins: to reduce cholesterol and plaque burden.
Beta Blockers: to reduce angina, prevent recurrent heart attack and sudden cardiac death.
Nitroglycerine compounds: to relieve angina & heart failure.
Calcium channel blockers: to relieve angina.
ACE Inhibitors and Angiotensin Receptor Blockers: to improve signs and symptoms of heart failure, help favorable remodeling of heart muscle and pumping function after a heart attack and to prolong life.
Aspirin and Glycoprotein 2b 3a inhibitors: to prevent thrombosis(blood clotting) in the coronary arteries.
Balloon Angioplasty/Stent and Coronary Artery Bypass Graft surgery: To reestablish blood flow through previous blockages.
Implantable devices: Cardiac Defibrillators to prevent life threatening arrhythmias and Biventricular Pacing to improve heart pumping.
Heart transplant: for people with severe cardiac disability
Cardiac rehabilitation: For patients with cardiac disability.
Obviously primary prevention is the best prevention!
Who should be tested / Contact information for RICADIA project?
People from India, Pakistan Sri Lanka and Bangladesh living in USA. Please call (619) 229-1995 or email pkotha@heartsmart.info.
Do I pay for my tests out of my pocket?
When funds are available and if you meet the inclusion criteria for a study in Asian Indians, all study related costs are paid by the sponsor. But keep in mind that many studies are designed to target a specific age or gender or the efficacy of two or more medications and as such very few individuals qualify for a specific study where as every one needs to be tested at least once. But the good news is that these tests are covered by a majority of health insurance plans.
Summary of RICADIA project
Asian Indians have the highest risk of heart disease among all ethnicities and women are no exception.
Life long vegetarians are at as high a risk as non-vegetarians.
Sedentary life styles and unhealthy cooking habits contribute a great deal to heart disease in Asian Indians. High incidence of metabolic syndrome, pre-diabetes and diabetes in Asian Indians.
Aim of the RICADIA project is to help identify the individual and family at risk for heart disease and provide specific diet, lifestyle and pharmacologic advice customized to each subject to prevent heart disease at the earliest stage possible.
Remember, it is never too early when it comes to prevent heart disease because ‘fatty streaks’ appear as early as in the second trimester of intrauterine life in fetuses of mothers who have high cholesterol.
The required tests are covered by most insurance plans.
Please click on Asian Indian studies in 'Patient Education' to learn more about the DIA and NAIHDP studies we have conducted in Indians. Click on 'AAPI Indian American Health' on our home page for additional info!
If you have any questions or if you would like to schedule an appointment, please call (619) 229-1995 or email pkotha@heartsmart.info.
Your proactive role is important to prevent premature disability and deaths associated with Coronary Artery Disease in Indians. Please share this information with your family and friends.
Contributions made to RICADIA are tax deductible and are utilized for the betterment of society in general and Indian community in particular. Please take charge of your health and be part of the solution. Checks should be made payable to RICADIA project and mailed to:
RICADIA Project. 5555 reservoir drive, suite 309 San Diego CA 92120
