title: Cardiovascular risk factors in Montana American Indians with and without diabetes.
abstract: BACKGROUND
  Cardiovascular disease (CVD) and diabetes are prevalent and of major concern for American-Indian communities in the United States. Health professional counseling is effective in increasing patient awareness and inducing lifestyle modification. The objective of this study was to compare the prevalence of CVD, modifiable risk factors and counseling for smoking cessation, physical activity, and a healthy diet in adult American Indians with and without diabetes.
  
  
  METHODS
  A random sample of adult American Indians living on or near the seven Montana reservations was interviewed through an adapted Behavioral Risk Factor Surveillance System telephone survey in 1999 (N=1000) and 2001 (N=1006).
  
  
  RESULTS
  Respondents with diabetes, compared to those without, had a significantly higher prevalence of CVD (27% vs 8%); overweight (89% vs 71%); high blood pressure (57% vs 24%); and high cholesterol (44% vs 22%). There were no differences for insufficient physical activity (60% vs 51%) or smoking (34% vs 41%) after adjustment for age, gender, and survey year. Respondents with diabetes, compared to respondents without diabetes, were significantly more likely to report health professional counseling for smoking cessation (83% vs 58%); physical activity (73% vs 37%); and reduced fat consumption (57% vs 24%).
  
  
  CONCLUSIONS
  The prevalence of modifiable CVD risk factors was alarmingly high among adult American Indians with and without diabetes. Strategies to increase health professional counseling for healthy diet and smoking cessation are needed.
authors.affiliation: Montana Department of Public Health and Human Services, Helena, Montana 59620-2951, USA. tharwell@state.mt.us
authors.forename: Todd S
authors.initials: TS
authors.lastname: Harwell
authors.forename: Kelly
authors.initials: K
authors.lastname: Moore
authors.forename: Janet M
authors.initials: JM
authors.lastname: McDowall
authors.forename: Steven D
authors.initials: SD
authors.lastname: Helgerson
authors.forename: Dorothy
authors.initials: D
authors.lastname: Gohdes
mesh_terms: D000328:Adult; D002318:Cardiovascular Diseases / Q000208:ethnology*; D003920:Diabetes Mellitus / Q000208:ethnology*; D004032:Diet; D015444:Exercise; D005260:Female; D006306:Health Surveys; D006801:Humans; D007198:Indians, North American / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D009009:Montana / Q000453:epidemiology; D012307:Risk Factors; D016540:Smoking Cessation