title: Changes in cardiovascular disease risk factors among American Indians. The Strong Heart Study.
abstract: OBJECTIVE
  This study describes changes in cardiovascular disease (CVD) risk factors in older American Indians over a 4-year period.
  
  
  METHODS
  The Strong Heart Study, a longitudinal population-based study of CVD and CVD risk factors among American Indians aged 45-74 years, measured CVD risk factors among 3638 members of 13 tribes in three geographic areas during examinations in 1989 to 1991 and 1993 to 1995.
  
  
  RESULTS
  Changes in mean low-density lipoprotein (LDL) cholesterol and the prevalence of elevated LDL cholesterol were inconsistent. Mean high- density lipoprotein (HDL) cholesterol decreased, and the prevalence of low HDL cholesterol increased throughout. Mean systolic blood pressure and hypertension rates increased in nearly all center-sex groups, and hypertension awareness and treatment improved. Smoking rates decreased but remained higher than national rates except among Arizona women. Mean weight and percentage body fat decreased in nearly all center-sex groups but the prevalence of obesity did not change significantly in any group. Diabetes and albuminuria prevalence rates increased throughout the study population. The prevalence of alcohol use decreased, but binge drinking remained common in those who continued to drink.
  
  
  CONCLUSIONS
  Improvements in management and prevention of hypertension, diabetes, renal disease, and obesity, and programs to further reduce smoking and alcohol abuse, are urgently needed.
authors.affiliation: Aberdeen Area Tribal Chairmen's Health Board, Rapid City, SD, USA.
authors.forename: Thomas K
authors.initials: TK
authors.lastname: Welty
authors.forename: Dorothy A
authors.initials: DA
authors.lastname: Rhoades
authors.forename: Fawn
authors.initials: F
authors.lastname: Yeh
authors.forename: Elisa T
authors.initials: ET
authors.lastname: Lee
authors.forename: Linda D
authors.initials: LD
authors.lastname: Cowan
authors.forename: Richard R
authors.initials: RR
authors.lastname: Fabsitz
authors.forename: David C
authors.initials: DC
authors.lastname: Robbins
authors.forename: Richard B
authors.initials: RB
authors.lastname: Devereux
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Henderson
authors.forename: Barbara V
authors.initials: BV
authors.lastname: Howard
mesh_terms: D000368:Aged; D000428:Alcohol Drinking / Q000009:adverse effects / Q000453:epidemiology; D001794:Blood Pressure / Q000502:physiology; D002318:Cardiovascular Diseases / Q000097:blood / Q000208:ethnology* / Q000209:etiology*; D003920:Diabetes Mellitus / Q000097:blood / Q000453:epidemiology / Q000652:urine; D005260:Female; D006801:Humans; D007198:Indians, North American / Q000523:psychology; D008055:Lipids / Q000097:blood; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects / Q000453:epidemiology; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology
chemical_list: D008055:Lipids