According to a scientific statement published in the American Heart Association journal Circulation, type 2 diabetes affects American Indians and Alaska natives at approximately 3 times the rate of white Americans and is closely linked to disproportionately high rates of cardiovascular disease.
The statement notes that among the 5.2 million Americans who self-identify as American Indian or Alaska native, heart disease rates are 50% higher than white Americans, with one-third of deaths that occurred in a person from these populations before they were age 65 were attributed to cardiovascular disease.
The greatest risk factor for cardiovascular disease among these groups is type 2 diabetes, which is exacerbated by social determinants of health experienced by this population. Obesity is an epidemic among American Indians and Alaska natives, it is estimated that 30% to 40% of American Indians have obesity. The Strong Heart Study, cited in the statement, found that only some of the risk for obesity and diabetes is genetically inherited.
Nearly 32% of American Indians and Alaska natives use tobacco, a rate nearly twice as high as other ethnic populations in the US. In addition to individual risk factors, exposure to toxic metals from groundwater contamination is particularly high in the Midwest and Southwest. Toxic metal exposure to arsenic and cadmium are associated with increased atherosclerosis and total cholesterol levels in several American Indian populations.
“There are urgent cardiovascular health risks for American Indians and Alaska natives that healthcare professionals and policy makers should not ignore,” said Khadijah Breathett, MD, MS, FAHA, assistant professor of medicine, cardiology, University of Arizona. “Healthcare providers must individualize care by identifying the individual patient’s needs and matching them to the appropriate resources such as community-based interventions.”
Stephen M. Gollomp, MD, and Paul G. Mathew, MD, DNBPAS, FAAN, FAHS
Natalia P. Rocha, PharmD, MSc, PhD; Gabriela D. Colpo, PhD; Antonio L. Teixeira, MD, PhD, MSc; and Erin Furr Stimming, MD
Vanessa Baute Penry, MD; Rachana Gandhi Mehta, MD; and Fatemeh Sadeghifar, BS