The age adjusted death rates for cerebrovascular disease are declining more rapidly in the general U.S. population than in Native Americans, with Native American rates now approximately 5% greater than the general U.S. population. In addition, in the face of an epidemic of type 2 diabetes, increasing rates of hypertension and coronary artery disease, there is a concern that we may see an actual increase in stroke rates over the next several decades. Peripheral vascular disease rates also appear to be increasing among Native Americans.

It is clear that the development of significant additional resources are vital to appropriately address these inequities in health in order to reduce the incidence, severity and long term complications of Cardiovascular Disease among Native Americans. Although secondary and tertiary preventative activities have clearly been shown to be extremely beneficial and require significant expansion and increased scope, primary prevention activities related to these and other chronic diseases should be primarily focused on lifestyle modification within Native American communities, with a strong focus on Native American youth.