The increasing incidence of coronary artery disease and cardiovascular risk factors among a Southwest Native American tribe: the White Mountain Apache Heart Study.
BACKGROUND
Rates of cardiovascular disease and its risk factors seem to be increasing in American Indian populations, yet these changes have received little documentation.


OBJECTIVE
To evaluate incidence rates of coronary artery disease, acute myocardial infarction, and cardiac events during a 10-year period (1987-1996); to assess cardiac risk factors for an American Indian tribe in Arizona.


METHODS
A retrospective medical chart review was performed for tribal members from January 1, 1987-December 31, 1996. Patient records with even minor indications of coronary disease were reviewed independently by 2 cardiologists of the Native American Cardiology Program. Multiple databases were reviewed in an effort to find all diagnoses, and incidence rates were calculated and analyzed for increasing trends. Cardiac risk factors were assessed in a population convenience sample.


RESULTS
From 1987 through 1996, the number of incident cases increased from 3 to 18 for coronary artery disease, 1 to 10 for acute myocardial infarction, and 3 to 26 for cardiac events. Statistically significant increasing trends were calculated for each. Of our youthful convenience sample, 49% had 2 or more cardiac risk factors.


CONCLUSIONS
This study confirms increasing rates of coronary artery disease and its comorbidities in this American Indian population and demonstrates high prevalence of cardiovascular risk factors among tribal members without extant coronary disease. This suggests that coronary disease will likely continue to increase as this population ages. To prevent such increases, culturally appropriate, aggressive preventive interventions are needed.
Sewell
Justin L
JL
Native American Cardiology Program, University of Arizona, Tucson, AZ, USA.
Malasky
Beth R
BR
Gedney
Curtis L
CL
Gerber
Trevor M
TM
Brody
Eric A
EA
Pacheco
Edith A
EA
Yost
David
D
Masden
Betty R
BR
Galloway
James M
JM
D000328:Adult; D000368:Aged; D001130:Arizona / Q000453:epidemiology / Q000208:ethnology; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000208:ethnology; D003327:Coronary Disease / Q000175:diagnosis* / Q000208:ethnology* / Q000209:etiology; D048909:Diabetes Complications; D005260:Female; D006801:Humans; D015994:Incidence; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000208:ethnology; D009765:Obesity / Q000150:complications; D010353:Patient Education as Topic; D015995:Prevalence; D012189:Retrospective Studies; D012307:Risk Factors; D014481:United States / Q000453:epidemiology