Taking aim at the leading health risk for American Indians

While heart disease among most Americans has decreased over the past 50 years, American Indians are almost twice as likely to develop the condition as other Americans, a study supported by the National Heart, Lung, and Blood Institute (NHLBI) has found. Heart disease is now the leading cause of death among American Indians.

The NHLBI, part of the National Institutes of Health, funded the Strong Heart Study to provide insight into the causes of heart disease and its risk factors in the American Indian population.

The study, which began in 1988, includes health data from more than 7,600 volunteers among 13 communities in parts of Arizona, Oklahoma, and North and South Dakota. The study’s findings show that cardiovascular disease (CVD) rates in the American Indian population are almost twice as high as the rest of the U.S. population, and diabetes is a key risk factor for the development of heart disease among this group. Similar to the general U.S. population, risk factors such as high blood pressure, high cholesterol, and cigarette smoking may also account for the high rates of heart disease in the American Indian population.

Researchers believe that many of these risk factors may have increased among American Indians because of cultural changes over the last 50 years, such as a reduction in physical activity, changes in diet and increased rates of smoking.

“Many rural Indians live on reservations, where it is difficult to get access to fresh, healthful foods,” says Dr. Amanda Fretts, an American Indian epidemiologist and an assistant professor at the University of Washington Department of Epidemiology. She is a member of the Mi’kmaq tribe, which is based in Eastern Canada. “Our study suggests that limiting processed meat should be part of a heart healthy diet. Although these analyses used data from the Strong Heart Study, the findings may be useful to other underserved or rural communities throughout the United States. The Strong Heart Study continues to be a valuable health resource.”

Currently, researchers involved in the Strong Heart Study are trying to identify a genetic basis for heart disease in the Indian population. Using blood samples, the scientists are trying to understand how genes might affect cholesterol, blood pressure and other risk factors related to heart disease. This could lead to new approaches for preventing or treating heart disease in the future.

Dr. Everett Rhoades, a former director of the Indian Health Service and a member of the Kiowa Nation of Oklahoma, said that the study is notable not only for sharing information about heart disease, but for empowering the Indian community to take charge of its own health.

“The Strong Heart Study provides a reason to be optimistic that the health of the American Indian people will improve in the future,” Rhoades says. “More and more Indians are now adopting positive health habits, including better fitness and diet, than in the past. And there’s a growing perception that this study is saving lives. However, real progress will depend upon continued clinical or epidemiologic studies such as that exemplified so splendidly by the Strong Heart Study, which has set the standard for such studies conducted among American Indian populations.”

The longest running study of its kind, the Strong Heart Study has raised awareness about American Indian health and the health of rural America and underserved communities. The study’s results will continue to offer ideas to help reduce the burden of heart disease, diabetes, and other conditions that disproportionately affect American Indians as well as many other populations.

For more information about the Strong Heart Study, visit https://www.nhlbi.nih.gov/research/resources/obesity/population/shs.htm.

 

 


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