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Cardiovascular disease among American Indians and Alaska Natives
1Aberdeen Area Indian Health Service, Rapid City, South Dakota 57702.
Insights
Cardiovascular disease (CVD) mortality is lower in American Indian/Alaska Native (AI/AN) populations compared to the general U.S. population. However, regional disparities and risk factors like diabetes highlight the need for targeted prevention strategies for AI/AN CVD.
Area of Science:
- Public Health
- Epidemiology
- Cardiovascular Medicine
Background:
- Cardiovascular disease (CVD) poses a significant public health challenge globally.
- Understanding regional variations in CVD prevalence and mortality is crucial for effective health interventions.
Purpose of the Study:
- To compare regional CVD differences between American Indian/Alaska Native (AI/AN) populations and the general U.S. population.
- To determine the parity gap and the preventable proportion of CVD mortality among AI/AN.
Main Methods:
- Utilized age-adjusted CVD mortality rates (1981-1983) and hospital discharge rates (1982-1984) from the Indian Health Service (IHS) and U.S. data.
- Compared rates to identify regional disparities and potential for prevention.
Main Results:
- AI/AN populations generally exhibit lower rates of ischemic heart disease and atherosclerosis.
- However, the 25-44 age group shows higher CVD death rates compared to the general U.S. population.
- While overall AI/AN CVD mortality is 19% lower, regional parity gaps vary significantly, with substantial room for preventable mortality reduction.
Conclusions:
- Future trends may see increased CVD prevalence in AI/AN due to changing lifestyles and rising diabetes rates.
- Regional variations in risk factors (smoking, hypertension, hypercholesterolemia, diabetes) likely explain observed CVD morbidity and mortality differences.
- Targeted prevention and treatment of these risk factors, alongside moderated alcohol consumption, are key to reducing CVD burden in AI/AN communities.
Objective:
To compare the regional differences in cardiovascular disease in AI/AN with the U.S. general population and determine the parity gap and preventable proportion of cardiovascular mortality.
Research Design And Methods:
Age-adjusted cardiovascular disease mortality rates for 1981-1983 and hospital discharge rates for 1982-1984 reported by the IHS were compared with U.S. data for 1982 and 1983, respectively.
Results:
Rates of ischemic heart disease and atherosclerosis were found to be generally low among AI/AN although those in the 25- to 44-yr age-group have higher death rates from cardiovascular disease than in the U.S. population. Although the mortality rate from cardiovascular disease in AI/AN is 19% lower than the rate for the general U.S. population, the parity gap in individual regions of the U.S. ranges from favorable to extremely unfavorable. There were also wide variations in the preventable gap theoretically possible by reduction of the three major risk factors.
Conclusions:
Changing nutrition and exercise patterns and the increasing prevalence of diabetes in many Indian tribes may have adverse effects in the future, possibly increasing the prevalence of heart disease. Regional differences in the prevalence of some major cardiovascular risk factors (smoking, hypertension, hypercholesterolemia, and diabetes) are the probable explanation for these differences in cardiovascular morbidity and mortality rates. Prevention and treatment of these risk factors will have the greatest impact in attempts to reduce cardiovascular disease among AI/AN. In addition, moderation in the use of alcohol, or abstinence, may prevent sudden deaths resulting from acute intoxication.
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