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U.S. Rep. Pramila Jayapal (D-Seattle) met Thursday, March 29, with heart specialists at UW Medical Center. She has introduced a bill in this session of Congress to increase research of heart health among South Asians, the fastest-growing ethnic group in the United States and one whose risk of developing heart disease is four times the rate of the general population.

It’s an alarming problem that lacks awareness nationally, said Dr. Sandeep Krishnan, a UW Medicine cardiologist.

“Though South Asians may appear to be relatively skinny, they have a higher degree of visceral fat than other populations,” Krishnan said. “South Asians’ diet is typically vegetarian but high in carbs, and their genetics are such that they don’t seem to metabolize carbohydrates as well as the rest of the world. This leads to higher incidence of diabetes, which is inherently linked with cardiovascular disease.”

Rep. Jayapal toured the cardiac catheterization lab, learned about different procedures performed at UWMC, and discussed a matter important to our cardiology practices: obstacles to getting prior authorizations from insurers for patients’ care.

She said it was a vexing issue she had dealt with in the Washington State Senate. Prior authorization refers to the need to have certain procedures or drugs approved in advance by a patient’s health insurer to get them reimbursed. Dr. Eugene Yang, Dr. James McCabe and Dr. Krishnan all shared anecdotes of a frustrating cycle of denials and appeals that left patients waiting for life-altering care, sometimes literally on the OR table.

Rep. Jayapal pledged to look at the question of prior authorization and what can be done at the federal level to address it. She’ll also work to advance H.R. 3592.

Increasingly, population-based medical data indicates that different ethnic groups have different genetic dispositions to disease and illness.

“Disproportionate levels of heart disease in the South Asian community are a red flag with a preventable cause,” Rep. Jayapal said in introducing the bill. “By dedicating funding to research and ways to get the word out on the importance of heart health, we will not only save more lives in the South Asian community, we will also open a door to a new and better understanding of heart health that will benefit all Americans.”

Currently South Asian patients make up a minority of the randomized subjects included in clinical trials funded by the National Institutes of Health. That makes it challenging to try to draw conclusions about that population, Krishnan said, so research more specifically focused on South Asians would be helpful.


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