Cardiovascular disease risk factors among American Indians. The Strong Heart Study.

The Strong Heart Study, a study of cardiovascular disease among American Indians, was conducted to determine cardiovascular disease rates and the prevalence of cardiovascular disease risk factors among members of 13 tribal groups in Arizona, North Dakota/south Dakota (ND/SD), and Oklahoma. This report was written to document differences between the tribal groups so that health professionals and tribal communities can intervene to diminish the risks that are most prevalent. From 1989 to 1992, 4,549 tribal members aged 45-74 years (62% of eligible participants) were surveyed and examined for cardiovascular disease and its risk factors. Data were collected through physical examinations and interviews. Cholesterol levels varied by tribal group with the Arizona tribes having the highest levels. The prevalence of hypercholesterolemia was almost twice as high among ND/SD Indians as among Arizona tribes. The prevalence of hypertension among Arizona and Oklahoma Indians has higher than the ND/SD tribes. Cigarette smoking was relatively high in the ND/SD and Oklahoma tribal groups. Arizona tribes had the highest rates of diabetes mellitus. Proteinuria and the prevalence of obesity was common among all tribal groups. The results of the study indicate that cardiovascular disease risk factors vary significantly among tribal groups. Prevention programs tailored toward decreasing the prevalence of risk factors are recommended for long-term reduction of cardiovascular disease rates in American Indian communities.