| ||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||||
(Hypertension. 1996;28:256-264.)
© 1996 American Heart Association, Inc.
Articles |
Hypertension in Adult American Indians
The Strong Heart Study
the Medlantic Research Institute, Washington, DC (B.V.H.); Center for Epidemiologic Research, University of Oklahoma Health Sciences Center, Oklahoma City (E.T.L., J.L.Y., O.G.); National Heart, Lung, and Blood Institute, Bethesda, Md (R.R.F.); Cornell Medical Center, New York, NY (R.B.D.); and Aberdeen Area Indian Health Service, Rapid City, SD (T.K.W.).
Hypertension is a primary risk factor for cardiovascular disease in the United States. Although cardiovascular disease is the leading cause of death among American Indians, the prevalence of hypertension, its awareness and control, and its association with other cardiovascular disease risk factors and physiological variables have not been well studied in this population. The Strong Heart Study is a longitudinal study of cardiovascular disease and its risk factors in American Indians. Participants (2703 women and 1846 men) were members of 13 tribes in central Arizona, southwestern Oklahoma, and regions of South and North Dakota. At least 1500 individuals between 45 and 74 years of age participated from each center in a baseline clinical examination conducted between July 1989 and January 1992. The examination consisted of a personal interview and physical examination that included an oral glucose tolerance test and three consecutive blood pressure measurements. This study reports data from the baseline examination on the prevalence of hypertension and correlates of blood pressure. Results indicated that despite the high frequency of diabetes and obesity, prevalence rates of hypertension in Arizona and Oklahoma were similar to those in the US population in the Third National Health and Nutrition Examination Survey (NHANES III), and rates among South/North Dakota participants were significantly lower (P<.0001). Blood pressure was higher in individuals with diabetes (P<.0001) and was significantly correlated with age (P<.0001) and albuminuria (P<.0001) but only weakly related to obesity. There was no independent relation between blood pressure and insulin. Blood pressure seems to be less affected by obesity and hyperinsulinemia in American Indians compared with other populations. Nevertheless, hypertension should be aggressively treated and controlled in American Indians because it is a known precursor to morbidity and mortality associated with diabetes and cardiovascular disease.
Key Words: Indians, North American • cardiovascular diseases • diabetes mellitus • ethnic groups
This article has been cited by other articles:
 |
|
 |
|
  M. De Marco, G. de Simone, M. J. Roman, M. Chinali, E. T. Lee, M. Russell, B. V. Howard, and R. B. Devereux Cardiovascular and Metabolic Predictors of Progression of Prehypertension Into Hypertension: The Strong Heart Study Hypertension, November 1, 2009; 54(5): 974 - 980. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 Y. Zhang, J. M. Galloway, T. K. Welty, D. O. Wiebers, J. P. Whisnant, R. B. Devereux, J. R. Kizer, B. V. Howard, L. D. Cowan, J. Yeh, et al. Incidence and Risk Factors for Stroke in American Indians: The Strong Heart Study Circulation, October 7, 2008; 118(15): 1577 - 1584. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
S. Cicala, G. de Simone, M. J. Roman, L. G. Best, E. T. Lee, W. Wang, T. K. Welty, J. M. Galloway, B. V. Howard, and R. B. Devereux Prevalence and Prognostic Significance of Wall-Motion Abnormalities in Adults Without Clinically Recognized Cardiovascular Disease: The Strong Heart Study Circulation, July 10, 2007; 116(2): 143 - 150. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 G. de Simone, R. B. Devereux, M. Chinali, L. G. Best, E. T. Lee, J. M. Galloway, H. E. Resnick, and for the Strong Heart Study Investigators Prognostic Impact of Metabolic Syndrome by Different Definitions in a Population With High Prevalence of Obesity and Diabetes: The Strong Heart Study Diabetes Care, July 1, 2007; 30(7): 1851 - 1856. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. T. Lee, B. V. Howard, W. Wang, T. K. Welty, J. M. Galloway, L. G. Best, R. R. Fabsitz, Y. Zhang, J. Yeh, and R. B. Devereux Prediction of Coronary Heart Disease in a Population With High Prevalence of Diabetes and Albuminuria: The Strong Heart Study Circulation, June 27, 2006; 113(25): 2897 - 2905. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. Wang, E. T. Lee, R. R. Fabsitz, R. Devereux, L. Best, T. K. Welty, and B. V. Howard A Longitudinal Study of Hypertension Risk Factors and Their Relation to Cardiovascular Disease: The Strong Heart Study Hypertension, March 1, 2006; 47(3): 403 - 409. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. Zhang, E. T. Lee, R. B. Devereux, J. Yeh, L. G. Best, R. R. Fabsitz, and B. V. Howard Prehypertension, Diabetes, and Cardiovascular Disease Risk in a Population-Based Sample: The Strong Heart Study Hypertension, March 1, 2006; 47(3): 410 - 414. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 J. A. Henderson, D. Buchwald, and S. M. Manson Relationship of Medication Use to Health-Related Quality of Life Among a Group of Older American Indians Journal of Applied Gerontology, February 1, 2006; 25(1_suppl): 89S - 104S. [Abstract] [PDF]
|
|
|
|
|
|
G. de Simone, R. B. Devereux, M. Chinali, M. J. Roman, L. G. Best, T. K. Welty, E. T. Lee, B. V. Howard, and for the Strong Heart Study Investigators Risk Factors for Arterial Hypertension in Adults With Initial Optimal Blood Pressure: The Strong Heart Study Hypertension, February 1, 2006; 47(2): 162 - 167. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
G. de Simone, R. B. Devereux, M. Chinali, L. G. Best, E. T. Lee, T. K. Welty, and for the Strong Heart Study Investigators Association of Blood Pressure With Blood Viscosity in American Indians: The Strong Heart Study Hypertension, April 1, 2005; 45(4): 625 - 630. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 D R Manna, M A Bruijnzeels, H G A Mokkink, and M Berg Ethnic specific recommendations in clinical practice guidelines: a first exploratory comparison between guidelines from the USA, Canada, the UK, and the Netherlands Qual. Saf. Health Care, October 1, 2003; 12(5): 353 - 358. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 N. E. Lebowitz, J. N. Bella, M. J. Roman, J. E. Liu, D. P. Fishman, M. Paranicas, E. T. Lee, R. R. Fabsitz, T. K. Welty, B. V. Howard, et al. Prevalence and correlates of aortic regurgitation in american indians: the Strong Heart Study J. Am. Coll. Cardiol., August 1, 2000; 36(2): 461 - 467. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
B. V. Howard, E. T. Lee, L. D. Cowan, R. B. Devereux, J. M. Galloway, O. T. Go, W. J. Howard, E. R. Rhoades, D. C. Robbins, M. L. Sievers, et al. Rising Tide of Cardiovascular Disease in American Indians : The Strong Heart Study Circulation, May 11, 1999; 99(18): 2389 - 2395. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 The Sixth Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Arch Intern Med, November 24, 1997; 157(21): 2413 - 2446. [Abstract] [PDF]
|
|
|
|
|
|
R. B. Devereux, M. J. Roman, G. de Simone, M. J. O'Grady, M. Paranicas, J. Yeh, R. R. Fabsitz, and B. V. Howard Relations of Left Ventricular Mass to Demographic and Hemodynamic Variables in American Indians : The Strong Heart Study Circulation, September 2, 1997; 96(5): 1416 - 1423. [Abstract] [Full Text]
|
|
|
|
|
|
C. I. Kiefe, O. D. Williams, D. E. Bild, C. E. Lewis, J. E. Hilner, and A. Oberman Regional Disparities in the Incidence of Elevated Blood Pressure Among Young Adults : The CARDIA Study Circulation, August 19, 1997; 96(4): 1082 - 1088. [Abstract] [Full Text]
|
|