Increasing prevalence of cardiovascular risk factors among American Indians in Montana

Oser, Carrie S.; Harwell, Todd S.; Strasheim, Carol; Fogle, Crystelle C.; Blades, Lynda L.; Dennis, Terry; Johnson, Elizabeth A.; Gohdes, Dorothy; Helgerson, Steven D.

doi:10.1016/j.amepre.2004.12.014

Cited by 14 publications

(10 citation statements)

References 12 publications

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“…20 The disparity in heart disease and stroke mortality rates in American Indians less than 65 years of age compared with whites in Montana is probably because of the higher and increasing prevalence of cardiovascular disease risk factors. 13,14 This highlights the importance of clinical and public health programs for the management and prevention of hypertension, high cholesterol, diabetes, obesity, and smoking.…”

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confidence: 99%

“…12 In Montana, the prevalence of cardiovascular risk factors in American Indian adults was significantly higher than in whites in 1999, and the prevalence of 2 or more risk factors for cardiovascular disease in Indian adults increased from 34% to 44% between 1999 and 2003. 13,14 Recent strategic recommendations emphasized the importance of regional data to provide accurate surveillance in the efforts to address disparities for all ethnic groups. 15 This is particularly important for American Indian communities in which there are significant variations in risk factor prevalence, and there is little current information about the temporal trends and disparities in either heart disease or stroke mortality in many regions of the United States.…”

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Defining Disparities in Cardiovascular Disease for American Indians

et al. 2005

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Background— Disparities in stroke and heart disease have been well defined in many populations in the United States. Relatively few studies, however, have assessed current disparities in cardiovascular disease in American Indian populations and compared trends with other regions of the United States. Methods and Results— Using mortality data, age-adjusted all-cause, heart disease, and stroke mortality rates (per 100 000) were calculated for American Indians and whites from 1991 to 1995 and 1996 to 2000. The all-cause mortality rate was strikingly higher for American Indians than for whites. For example, during 1996 to 2000, the all-cause mortality rate for American Indians (1317, ±61) was more than half again greater than that for whites (831, ±8). Heart disease mortality declined significantly in whites (237 to 216 per 100 000) in Montana over the past decade and declined, although not significantly, in American Indians (326 to 283 per 100 000). Stroke mortality also declined significantly in whites (64 to 60 per 100 000) but not in American Indians (80 to 81 per 100 000) during this time period. The proportion of deaths before age 65 years for heart disease and stroke was considerably higher in Indian men (45% and 36%) and Indian women (29% and 28%) compared with white men (21% and 11%) and white women (8% and 7%). Conclusions— The disparity in heart disease and stroke mortality exists between American Indians and whites in Montana. Regional or state-level surveillance data will be needed to describe the changing patterns of heart disease and stroke mortality and cardiovascular risk factors in many native communities in the United States and Canada.

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Defining Disparities in Cardiovascular Disease for American Indians

et al. 2005

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“…American Indians share the same risk factors as other populations, but have an increased susceptibility to and high prevalence of another important CVD risk factor—type 2 diabetes. In addition to the high rates of diabetes found among American Indians, there are also very high rates of tobacco use among some tribes [15–17]. When looking at multiple CVD risk factors simultaneously, Strong Heart Study investigations found smoking to be a risk factor for some subcategories of CVD but not others [18–21].…”

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confidence: 99%

Tobacco Use and Cardiovascular Disease among American Indians: The Strong Heart Study

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et al. 2010

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Tobacco use among American Indians has a long and complicated history ranging from its utilization in spiritual ceremonies to its importance as an economic factor for survival. Despite this cultural tradition and long history, there are few studies of the health effects of tobacco in this population. The Strong Heart Study is a prospective observational study of cardiovascular disease (CVD) in 13 American Indian tribes in Arizona, Oklahoma, and North and South Dakota with 4,549 participants. Baseline examinations were followed by two examinations at regular intervals and 16 years of morbidity and mortality follow-up. Hazard ratios (HRs) for non-fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.94, 95% CI 1.54 to 2.45) and men (HR = 1.59, 95% CI 1.16 to 2.18). Hazard ratios for fatal CVD for current smokers vs. non-smokers after adjusting for other risk factors were significant in women (HR = 1.64, 95% CI 1.04 to 2.58), but not in men. Individuals who smoked and who were diagnosed with diabetes mellitus, hypertension or renal insufficiency were more likely to quit smoking than those without these conditions. On average, American Indians smoke fewer cigarettes per day than other racial/ethnic groups; nevertheless, the ill effects of habitual tobacco use are evident in this population.

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“…355 them at a higher risk for CVD than other segments of the population. 5,6 According to the American Heart Association (AHA), the percentage of female deaths related to CVD was about 53% in 2000, 1 and it was the major cause of mortality of more than a half-million women. Following menopause, the incidence of CVD increases significantly 2,7-9 and is associated with elevations in circulating total cholesterol and low-density lipoprotein cholesterol (LDL-C) concentrations, placing postmenopausal…”

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