"Faces of Global Health" - Svati Shah, MD

SVATI SHAH

Published August 24, 2010, last updated on March 21, 2013 under Research News

The exploding burden of cardiovascular disease among low- and middle-income countries was the motivation for Duke cardiologist Svati Shah to consider research initiatives in her parents’ home country of India. She is among several highly-trained experts recruited by the Duke Global Health Institute to study the causes of this shift toward chronic diseases within an international context.

Shah, also trained in epidemiology and genomics, has established an adult cardiovascular disease genetics clinic at Duke University Medical Center. She said with the support of DGHI, her interest in genomics research abroad became possible.

“DGHI gave me the infrastructure and support I needed to be able to do global health research in India. So when DGHI came along, I leaped at the opportunity,” said Shah, assistant professor of medicine, whose research in India focuses on genomics and novel biomarkers in patients with cardiovascular disease (CVD) and diabetes. Today, she leads DGHI’s signature research initiative on cardiovascular diseases.

Worldwide, there are more deaths associated with CVD than from tuberculosis, HIV and malaria combined. “In fact, India has the largest number of diabetes cases in the world,” said Shah, who visited the country last year to explore possibilities for her research projects and build local partnerships. She saw patients who had not been diagnosed with diabetes until they suffered from an endstage complication, typically kidney failure, blindness or a heart attack.

It is Shah’s hope that her research will lead to earlier diagnosis of chronic diseases and fewer deaths among high-risk populations in India. She plans to determine whether findings from her epidemiological research among Caucasians, in which she found novel mechanisms for disease risk for diabetes and CVD, may be useful for risk prevention and targeting of vulnerable Indian populations. In addition to genetic influences on human health, Shah is also studying the extent to which environmental factors play a role in chronic disease risk among Indians.

“We believe the growing burden of heart disease, diabetes, and cancer is now producing the largest burden of public health in developing countries because people are living longer, eating Western diets, and developing sedentary lifestyles as they transition from rural to urban populations,” said Shah. “But, we don’t fully understand the epidemiological transition of the trend toward urban settings and its effect on chronic disease. We also don’t understand the underlying mechanisms of risk.”

Shah is partnering with the Indian biotechnology company, Jubilant, to fund long-term cohort studies and to help build a research infrastructure in Kolkata, where village women are being trained to deliver basic health care in their communities. Shah’s research team is also working with the New Delhi-based Public Health Foundation of India to analyze clinical data and biological samples from thousands of patients with diabetes and other chronic diseases to learn more about their natural history of disease and metabolomic profiles.

Shah’s genetic and epidemiological expertise is a unique fit for fieldwork in the underdeveloped area of cardiovascular global health. She is poised to make a difference for the people of India and beyond.

“We believe the growing burden of heart disease, diabetes, and cancer is now producing the largest burden of public health in developing countries."

- Svati Shah

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