Cardiovascular disease among Alaska Natives: a review of the literature.

BACKGROUND: We reviewed the literature of population-based studies regarding heart disease and stroke occurrence among Alaska Natives. The existing literature suggests that differences in cardiovascular mortality rates and risk factors exist in Alaska Natives by ethnicity and residence. However, data sources are largely limited to mortality data and small community-based studies.
OBJECTIVES: Because cardiovascular disease occurrence has not been well studied among Alaska Natives, it is important to avoid sweeping generalizations about the increasing or decreasing prevalences of cardiovascular disease and risk factors.
RESULTS: Recent mortality rates from heart disease (of all types) among Alaska Natives are similar to rates for U.S. whites, and mortality rates from stroke among Alaska Natives are higher than rates for U.S. whites. Mortality rates from ischemic heart disease have been relatively constant among Alaska Natives over the past 20 years, while over the same time period, rates declined dramatically among U.S. Whites. The ischemic heart disease mortality rates among Alaska Native males are now comparable to rates among U.S. White males.
CONCLUSIONS: Although available data indicate no increase in mortality from ischemic heart disease in Alaska Natives, the relatively constant death rates over the recent 20 years, compared with declining rates elsewhere in the U.S, and the high prevalence of risk factors for ischemic heart disease calls for increased descriptive epidemiologic studies of the incidence and prevalence of cardiovascular disease outcomes. In addition, analytic epidemiologic studies are needed to examine the relationship between lifestyle, especially subsistence and traditional lifestyles, and cardiovascular disease outcomes.