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Presented at heart association conference: Ethnic group stroke rate trends show marked differences

Steve Sidney and Preety Kalra meet to discuss her research results presentation.

Steve Sidney, MD, at left and Noelle Blick, center, coached Preety Kalra, PhD, on how to improve the study presentation she was to give to the American Heart Association’s 51st Cardiovascular Disease Epidemiology and Prevention Conference. Her results earned her a nomination as one of four finalists for the Jeremiah and Rose Stamler Research Award for New Investigators.

Born in India and raised in the San Francisco Bay Area by Indian parents each working two jobs, Preety Kalra, MS, PhD, has seen first-hand the toll that stress and overwork can take on new immigrants. Her mother, a painter who sold her artwork at craft fairs, had a heart attack in her late 40s. Her father, who worked as a laborer in a glass factory, had cancer in his 50s.

This sparked Kalra to devote her early career to conducting community-based research for health advocacy organizations and later to population health epidemiology, particularly to answering the question: Why do some people get cardiovascular diseases and others don’t?

Now starting her second year as a staff scientist at Kaiser Permanente’s Division of Research, Kalra has just completed a study that begins to answer that question.

She examined 10-year trends by race/ethnicity in the incidence of hospitalized heart attacks among Kaiser Permanente members in Northern California. And her results — presented in March at the 51stCardiovascular Disease Epidemiology and Prevention Conference sponsored by the American Heart Association — earned her a nomination as one of four finalists for the Jeremiah and Rose Stamler Research Award for New Investigators.

Kalra’s team examined data from more than 45,000 Kaiser Permanente Northern California members who suffered heart attacks from 1999 to 2008. Over that period, they found significant declines in heart attacks in all four major race/ethnic groups, particularly in more severe heart attacks known as STEMIs.

Her work builds on previous research published in June 2010 in the New England Journal of Medicine by a team led by Division scientist Alan Go, MD. That study found that since 2000, heart attacks among the members of Kaiser Permanente Northern California had declined by 24 percent.

Kalra found significant differences between the downward trends of the four groups: Asian/Pacific Islander, Black, Hispanic and White. African-Americans showed the biggest decline in STEMIs, a 13 percent decrease over that 10-year period.

There is limited data in the literature for all four of the major race/ethnic groups, says Kalra, explaining that this study was a chance to begin exploring possible differences among all the groups over an extensive time period

Kalra draws on her community-based research experience for health advocacy groups to suggest that differences in cultural and communication patterns between race/ethnic groups, and even between different post-immigration generations of the same groups, may play major roles in health outcomes.

Before joining the Division, Kalra spent several years working at nonprofit health advocacy groups like the Asian & Pacific Islander American Health Forum and the National Asian Women’s Health Organization.

Kalra’s background and skills, and her deep interests in disparities research were pivotal to the decision to ask her to join the Division, says Steve Sidney, MD, associate director for Clinical Research at the Division. “I was very interested in having somebody who was passionate about doing race, ethnic and other kinds of disparities work in the CARDIA study and in the CVRN surveillance study,” said Sidney.

Kalra says her goal is to examine how the roots of health outcome disparities — including childhood risk factors and contextual factors related to the family, community or neighborhood — connect to adverse health outcomes later in life.

“To truly understand health disparities and learn how to predict adult health behavior, we must examine the life course, beginning in childhood,” she said.

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