Low incidence of cardiovascular disease among the Inuit--what is the evidence?
BACKGROUND
The notion that the incidence of ischemic heart disease (IHD) is low among the Inuit subsisting on a traditional marine diet has attained axiomatic status. The scientific evidence for this is weak and rests on early clinical evidence and uncertain mortality statistics.


METHODS
We reviewed the literature and performed new analyses of the mortality statistics from Greenland, Canada, and Alaska.


RESULTS
The evidence for a low mortality from IHD among the Inuit is fragile and rests on unreliable mortality statistics. Mortality from stroke, however, is higher among the Inuit than among other western populations. Based on the examination of 15 candidate gene polymorphisms, the Inuit genetic architecture does not obviously explain putative differences in cardiovascular disease prevalence.


CONCLUSIONS
The mortality from all cardiovascular diseases combined is not lower among the Inuit than in white comparison populations. If the mortality from IHD is low, it seems not to be associated with a low prevalence of general atherosclerosis. A decreasing trend in mortality from IHD in Inuit populations undergoing rapid westernization supports the need for a critical rethinking of cardiovascular epidemiology among the Inuit and the role of a marine diet in this population.
Bjerregaard
Peter
P
Division for Research in Greenland, National Institute of Public Health, Svanemøllevej 25 Copenhagen Ø, Denmark. p.bjerregaard@dadlnet.dk
Young
T Kue
TK
Hegele
Robert A
RA
D000328:Adult; D017677:Age Distribution; D000368:Aged; D000413:Alaska / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D002318:Cardiovascular Diseases / Q000175:diagnosis* / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D006116:Greenland / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D004930:Inuit / Q000235:genetics*; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D018570:Risk Assessment; D017678:Sex Distribution; D015996:Survival Rate