June 2, 2000

Facts About Heart Disease and Stroke Among American Indians and Alaska Natives

Heart disease and stroke, the principal causes of cardiovascular disease, are the first and fifth leading causes of death among American Indians and Alaska Natives (AI/AN). Risk factors often occur together and as the number of risk factors increases, so does the likelihood of heart disease and stroke.

Results from a national telephone survey by the Centers for Disease Control and Prevention (CDC) show that 63.7% of American Indian/Alaska Native (AI/AN) men and 61.4% of AI/AN women reported having one or more of the following risk factors for heart disease and stroke: high blood pressure, current cigarette smoking, high cholesterol, obesity, and diabetes.

• 22% of respondents (21.0% of men and 23.0% of women) said they had been told by a health professional that they had high blood pressure.
• 31% (32.8% of men and 28.8% of women) reported that they were current smokers.
• Almost 16% had been told by a health care professional that they had high cholesterol and more than 7% were told that they had diabetes.
• Nearly a fourth of men (23.6%) and nearly one-fifth of women (19.1%) were obese (21.5% of all AI/AN).

Having more than one risk factor was more common among older men and women, people with less education, the unemployed, and those reporting their health status as fair or poor.

• Having 2 or more risk factors was highest among people 65 and older.
• More than a fourth of AI/AN men with less than a high school education reported 2 or more risk factors, compared to almost 15% of AI/AN men who were college graduates.
• AI/AN women with less than a high school education were almost 3 times more likely to report 2 risk factors than AI/AN women who had graduated from college.
• The percentage of unemployed women having 2 or more risk factors was almost three times higher than the percentage of employed women.
• Half of those who reported their health status as fair or poor (men, 50%/ women, 51%) reported having 2 or more risk factors compared with only about an eighth of those who reported health status as excellent or very good.

For men, having more 2 or more risk factors for heart disease and stroke was highest in the Midwest (26.1%) and lowest in the Northeast (13.8%). Less geographic variation was seen among women: having 2 or more risk factors was highest in the Northeast (28.0%) and lowest in the West (20.0%). Regional differences in heart disease and stroke risk factors and death rates may reflect differences in cultural backgrounds, historical circumstances, and socioeconomic conditions.

The high percentages of AI/AN men and women with multiple risk factors for heart disease and stroke highlights the importance of primary prevention activities among communities of AI/AN. Through the CDC’s Racial and Ethnic Approaches to Community Health (REACH 2010) program, two AI/AN communities are mobilizing and organizing resources to support programs designed to eliminate racial and ethnic disparities in CVD and diabetes.*

Tribal- and community-specific assessments of heart disease and stroke-related illness and deaths are needed to develop culturally relevant prevention programs and policies that support heart-healthy living and working conditions for AI/AN.

For additional state-specific information, contact the BRFSS coordinator in the state(s) of interest: http://www2.cdc.gov/nccdphp/brfss2/coordinator.asp

*For more information, contact Janis E. Campbell, coordinator, Chronic Disease Surveillance Unit, Oklahoma State Department of Health, at (405) 271-4072, extension 57129; or Jeff Bachar, principal investigator, Eastern Band of Cherokee Indians, at (828) 497-2254.

Contact: Kathy Harben
CDC, National Center for Chronic Disease Prevention and Health Promotion
(770) 488–5131

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