1. The incidence and mortality associated with cardiovascular disease has decreased over a generation in a Native American cohort, however, improvements in age-specific mortality amongst females has not been consistently demonstrated
Evidence Rating Level: 2 (Good)
High morbidity and mortality rates owing to cardiovascular disease (CVD) have been observed in Native American populations, exceeding rates seen in other ethnic and/or racial groups. The Strong Heart Study (SHS) is a population-based cohort study of CVD in Native Americans that was initiated in 1988, and has led to the formation of the Strong Heart Family Study (SFHS), comprised of large multi-generation families. In this cohort study, researchers used data from the combined SHS and SFHS cohorts to evaluate temporal changes in CVD prevalence, incidence and CVD-related mortality risk in this group. Researchers found that at all age ages, CVD incidence was lower in more recent birth cohorts, and observed in both men and women subgroups. For CVD incidence, the magnitude of relative risk (RR) was relatively unchanged over the years amongst females (range 0.39 to 0.50), while the RR steadily declined in men. CVD mortality also declined consistently among men, while there was no consistent improvement in age-specific mortality risk among women when comparing birth cohorts. This study therefore shows that CVD incidence has declined over a generation in a Native American cohort. However, consistent improvements in female CVD-related mortality have not been demonstrated, pointing to a need for targeted public health interventions amongst female Native Americans.
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