Cardiovascular disease risk factor awareness in American Indian communities: the strong heart study

To use data from the longitudinal Strong Heart Study (SHS) to determine the level of awareness about risk factors for heart disease among 13 populations of American Indians in Arizona, Oklahoma, and South/ North Dakota. The aim of this study is to assess awareness of nine major risk factors for heart disease among participants in SHS.

During July 1993 to December 1995 (phase II of SHS), 3638 participants ages 46 to 80 years (mean age 60) were asked if nine known risk factors for cardiovascular disease affect a person's chances of getting heart disease; 3226 (89%) participants completed the study and met the method reliability criteria for inclusion.

Among each of the nine risk factors, the percentage of correct answers provided by study participants ranged from 70% (family history of heart disease) to 90% (being very overweight). Participants with hypertension (90% vs 86%, P<.05) and diabetes mellitus (81% vs 71%, P<.05) were more likely than those without these disorders to know they were heart disease risk factors. For all nine risk factors, the percentage of correct answers was lower (P<.05) among smokers than among nonsmokers. In multivariate logistic regression analyses, female sex, advanced education, and being from Oklahoma were significantly associated with heart disease awareness.

Although overall risk factor awareness for heart disease was high, subgroups were identified who could benefit from culturally appropriate health education and other interventions to motivate health prevention actions, especially for smoking.