DIABETES
VOL. 45, SUPPLEMENT 3, JULY 1996
Diabetes and Coronary Heart Disease in American Indians
The Strong Heart Study
Barbara V. Howard, Elisa T. Lee, Richard R. Fabsitz, David C. Robbins, Jeunliang L. Yeh, Linda D. Cowan, and Thomas K. Welty
Coronary heart disease (CHD) is the leading cause of death
among American Indians. However, information on the prevalence of
CHD and its association with known risk factors is limited. The
purpose of the Strong Heart Study is to quantify CHD and its risk
factors among three geographically diverse groups of American
Indians. The population consists of 4,549 adults between 45 and
74 years of age in 13 Indian communities in Arizona, Oklahoma,
and South and North Dakota. The phase I examination (1989-1991)
revealed very high prevalence rates of diabetes that ranged from
33 to 72% in men and women in the three centers. Prevalence rates
of definite myocardial infarction (MI) and definite CHD were
higher in men than in women in all three centers (P <
0.0001) and in those with diabetes (P = 0.002 and P
= 0.0003 in women and men, respectively). Diabetes was associated
with a relatively greater increase in prevalence of MI
(prevalence rate = 3.8 vs. 1.9) and CHD (prevalence rate = 4.6
vs. 1.8) in women than in men. Logistic regression analysis
indicated that the prevalence of CHD among American Indians was
significantly related to age, diabetes, hypertension,
albuminuria, percentage of body fat, smoking, high concentrations
of plasma insulin, and low concentrations of HDL cholesterol.
Lower prevalence rates of CHD were found in Arizona despite
higher rates of diabetes, obesity, hypertension, and albuminuria;
these lower rates may be in part related to lower smoking
frequency and lower concentrations of total and LDL cholesterol.
These findings from the baseline Strong Heart Study examination
emphasize the relative importance of diabetes and its associated
variables as risk factors for CHD among American Indian
populations. Diabetes 45
(Suppl.3):S6-S13, 1996
Copyright © 1996 American Diabetes Association
Last updated: 7/15/96
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