American Indians/Alaska Natives and Cardiovascular Disease: Outcomes, Interventions, and Areas of Opportunity

Abstract

Purpose of Review: Cardiovascular disease (CVD) is a reported leading cause of death among American Indians and Alaska Natives (AI/ANs) and takes a disproportionate toll on these populations. Using the electronic database PubMed, the purpose of this review is to summarize findings from CVD morbidity/mortality outcome studies, as well as CVD and CVD risk factor intervention studies among AI/ANs, published in 2014 and 2015. Recent Findings: Eighteen empirical studies that focused on CVD outcomes and CVD/CVD risk factor interventions were reviewed. Four of five studies on CVD mortality found that CVD is a leading or second leading cause of death among AI/ANs and that CVD mortality is still disproportionately high compared to whites. Three studies examined smoking or high-fat diets and found an association between these risk factors and CVD. Two CVD prevalence studies did not find statistically significant differences between AI/ANs and whites; however, this may be due to specific sample characteristics of these particular studies. Seven of eight CVD/CVD risk factor intervention studies, ranging in type of interventions delivered and outcomes measured, found beneficial CVD/CVD risk factor outcomes. One study uniquely underscored historical trauma and social determinants of health as barriers to healthy living. Summary: CVD disproportionately burdens AI/AN communities. Large-scale studies that oversample for AI/ANs are needed to document the continuing effects of CVD among Indigenous communities and monitor their disparity status in CVD morbidity/mortality. More interventions with control or comparison groups are also needed to address CVD and CVD risk factors among AI/AN communities and document their effectiveness. In addition, collaborative community-based interventions that tackle root issues of CVD-related disparities and attend to social determinants of health are needed.