Cardiovascular Disease in American Indian and Alaska Native Youth: Unique Risk Factors and Areas of Scholarly Need

Deen, Jason F.; Adams, Alexandra; Fretts, Amanda M.; Jolly, Stacey E.; Navas‐Acien, Ana; Devereux, Richard B.; Buchwald, Dedra; Howard, Barbara V.

doi:10.1161/jaha.117.007576

Cited by 29 publications

(25 citation statements)

References 108 publications

(197 reference statements)

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“…In Montana, AI individuals die 14 years earlier from heart disease than people who are not AI, 11 years for those with diabetes, and 12 years for those with cerebrovascular disease (27). Despite their potential to lower mortality rates and improve quality of life, existing programs that address chronic illness management fail because they are not consonant with AI culture (28).…”

Section: Project 2: Báa Nnilahmentioning

confidence: 99%

Using Community-Based Participatory Research to Design, Conduct, and Evaluate Randomized Controlled Trials with American Indian Communities

et al. 2020

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Purpose and Objectives Academic literature indicates a need for more integration of Indigenous and colonial research systems in the design, implementation, and evaluation of randomized controlled trials (RCTs) with American Indian communities. In this article, we describe ways to implement RCTs with Tribal Nations using community-based participatory research (CBPR) principles and practices. Intervention Approach We used a multiple case study research design to examine how Tribal Nations and researchers collaborated to develop, implement, and evaluate CBPR RCTs. Evaluation Methods Discussion questions within existing tribal–academic partnerships were developed to identify the epistemologic, methodologic, and analytic strengths and challenges of 3 case studies. Results We identified commonalities that were foundational to the success of CBPR RCTs with Tribal Nations. Long-standing community–researcher relationships were critical to development, implementation, and evaluation of RCTs, although what constituted success in the 3 CBPR RCTs was diverse and dependent on the context of each trial. Respect for the importance of diverse knowledge systems that account for both Indigenous knowledge and colonial science also contributed to the success of the RCTs. Implications for Public Health Tribal–academic partnerships using CBPR RCTs must include 1) establishing trusted CBPR partnerships and receiving tribal approval before embarking on RCTs with Tribal Nations; 2) balancing tribal community interests and desires with the colonial scientific rigor of RCTs; and 3) using outcomes that include tribal community concepts of success as well as outcomes found in standard colonial scientific research practices to measure the success of the CBPR RCTs.

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Section: Project 2: Báa Nnilahmentioning

confidence: 99%

Using Community-Based Participatory Research to Design, Conduct, and Evaluate Randomized Controlled Trials with American Indian Communities

et al. 2020

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“…Specifically, tobacco use is a big concern in this population with 26.7% of AI/AN adults identifying as smokers compared to only 15.2% of Asian men, 17.3% of Hispanic men, 23.7% of non-Hispanic black men, and 23.9% non-Hispanic white men, after age-adjusted estimates [ 70 ]. Similarly, AI/AN women (20.7%) are more likely to be current cigarette smokers than Asian women (5.5%), Hispanic women (9.6%), non-Hispanic black women (17.6%), and non-Hispanic white women (20.9%) [ 12 ]. Physical inactivity is another important risk factor that contributes significantly to CHD development.…”

Section: Genetics Heritability and Other Risk Factors Contributementioning

confidence: 99%

“…As is the case in the U.S. population in general, CVD is also the leading cause of death in the AI/AN population [ 8 , 9 ]. However, the incidence of CVD in this population shows considerable variability, ranging from 15 to 28 per 1000 among AI/AN men and only 9 to 15 per 1000 in AI/AN women ages 45–74 [ 10 – 12 ], and the factors for this discrepancy remain unclear.…”

Section: Introductionmentioning

confidence: 99%

Diabetes and Associated Cardiovascular Complications in American Indians/Alaskan Natives: A Review of Risks and Prevention Strategies

Poudel

Zhou

Story

et al. 2018

Journal of Diabetes Research

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Diabetes mellitus (DM) is the seventh leading cause of death in the United States and the leading cause of death in the U.S. American Indian/Alaskan Natives (AI/ANs), who comprise only 2% of the total population. The AI/AN population has a high prevalence of DM in adults aged 20 years or older and is developing DM at a younger age than the general U.S. population. DM is a major risk factor for cardiovascular disease (CVD), and mortality from CVD is higher in AI/ANs than the general population, as is the prevalence of stroke and 1-year poststroke mortality for both genders when compared to non-Hispanic whites. A genome-wide scan found a number of chromosome linkages in the AI/AN population that suggest that genetic factors may contribute to their high risk of DM and CVD. Importantly, studies also suggest that in addition to race/ethnicity, cultural norms and historic conditions play important roles in the prevalence of DM and CVD in this population. Therefore, multiple factors should be taken into consideration when establishing prevention programs to decrease the prevalence of obesity, diabetes, and CVD incidence among adults and children in the AI/AN population. Prevention programs should focus on behavioral risk factors and lifestyle changes like encouraging smoking cessation, healthy diet, and increased physical activity while taking into consideration cultural, economic, and geographic factors.

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“…However, in other countries HTN was a CVD risk factor in males too; for instance, Sesso et al have demonstrated in a median follow-up of 10.8 years of United States males that the average of SBP, DBP and mean arterial pressure (MAP) are strong predictor for CVD incidence in men, with higher relative risk (RR) in men younger than 60 comparing to ≥ 60 years old (63). These differences might be related to the sociocultural, ethnic and genetic determinants of different regions, worldwide (64)(65)(66)(67). Also, in a research on the Iranian population of Tehran, it was found that female gender is a protective factor in developing HTN (68); this contrast nding in two regions of Iran (Mashhad and Tehran) may be related to lifestyle and diet habits (66).…”

Section: Discussionmentioning

confidence: 99%

“…These differences might be related to the sociocultural, ethnic and genetic determinants of different regions, worldwide (64)(65)(66)(67). Also, in a research on the Iranian population of Tehran, it was found that female gender is a protective factor in developing HTN (68); this contrast nding in two regions of Iran (Mashhad and Tehran) may be related to lifestyle and diet habits (66).…”

Section: Discussionmentioning

confidence: 99%

Role of Socio-demographic, Lifestyle, Psychological and Anthropometric Parameters on Cardiovascular Disease Risk Among Mashad Cohort Study Population

Asadi

Ghazizadeh

Yaghooti

et al. 2020

Preprint

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Introduction: Cardiovascular disease (CVD) is the leading cause of mortality and one of the main challenges for health systems worldwide. In this study, we aimed to evaluate the role of socio-demographic, lifestyle, psychological factors, anthropometric measurements, and presence of underlying diseases in CVD progression among a subpopulation of Iranian adults. Methods A total of 235 CVD patients were enrolled. The control group also included healthy and non-symptomatic individuals (n = 8405). Health and lifestyle questionnaires, the Beck’s anxiety inventory (BAI), Beck’s depression inventory (BDI) and the James and Schofield human energy requirements equations were completed for all participants. Anthropometric measurements were also evaluated in all subjects. Results After six years of follow-up, we found that there were significant positive correlations between CVD risk and age, body mass index (BMI), waist circumference (WC), waist-to-height ratio (WHtR), diabetes mellitus (DM) and family history (FH) of CVD in both genders; though, there was a significant negative correlation between physical activity level (PAL) and risk of CVD among men and women. Also hypertension (HTN), metabolic syndrome (MS), depression and anxiety were positively and higher education level was negatively associated with CVD events only in females. While, waist-to-hip ratio (WHR) was an independent predictor of CVD among males. Conclusion There are several modifiable and non-modifiable risk factors that were independently considered as CVD predictors among the MASHAD study population. It is recommended that the lifestyle modifications, development of local risk calculators and gender-related stratified strategies should be prioritized in order to prevent and manage CVD among the Iranian population.

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Cardiovascular Disease in American Indian and Alaska Native Youth: Unique Risk Factors and Areas of Scholarly Need

Cited by 29 publications

References 108 publications

Using Community-Based Participatory Research to Design, Conduct, and Evaluate Randomized Controlled Trials with American Indian Communities

Using Community-Based Participatory Research to Design, Conduct, and Evaluate Randomized Controlled Trials with American Indian Communities

Diabetes and Associated Cardiovascular Complications in American Indians/Alaskan Natives: A Review of Risks and Prevention Strategies

Role of Socio-demographic, Lifestyle, Psychological and Anthropometric Parameters on Cardiovascular Disease Risk Among Mashad Cohort Study Population

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