Cardiovascular health among American Indians and Alaska natives - Successes, challenges, and potentials
Cardiovascular health among American Indians and Alaska natives - Successes, challenges, and potentials
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DOI：
10.1016/j.amepre.2005.07.023
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发表时间：
2005-12-01
影响因子：
5.5
通讯作者：
Galloway, JM
中科院分区：
文献类型：
--
作者：
Galloway, JM
近40年前，心血管疾病的危险因素率很低，因此美国印第安人和阿拉斯加原住民的心血管疾病（CVD）率非常低。尽管最近为消除少数民族和少数民族人口的健康差异作出了大规模努力，但迄今为止，对美洲印第安人和阿拉斯加土著人的影响相对有限。事实上，在过去几十年中，心血管危险因素的发病率和流行率显著上升，包括糖尿病的流行。有证据表明，这些较高的心血管风险因素，包括烟草滥用、糖尿病、高血压和胆固醇水平升高，可能给美国印第安人和阿拉斯加原住民带来了心血管疾病的过重负担。美国印第安人和阿拉斯加原住民患心脏病和中风的比率现在高于美国总人口和美国白人。最近的评估表明，这些比率也高于美国其他族裔或种族的人口。此外，与其他族裔和种族相比，美洲印第安人和阿拉斯加原住民因心脏病过早死亡的比例要高得多。最近的一些预防举措和重点临床工作在减少心血管健康差异方面取得了有希望的进展，包括初级、初级和二级心血管预防工作，以及加强早期识别和治疗干预，以便在未来获得更有利的心血管结果。为了实现心脏健康和无中风的美国印第安人和阿拉斯加原住民的目标，在适当的政策和立法支持下，有必要实施一项积极的、资源合理的、协调健康促进、降低风险和疾病控制努力的系统计划。
With low rates of the risk factors for cardiovascular disease as recently as 40 years ago, the rates of cardiovascular disease (CVD) in American Indians and Alaska Natives were exceedingly low. Despite recent large-scale efforts to eliminate health disparities in ethnic and minority populations, the impact among American Indian and Alaska Natives to date has been relatively limited. Indeed, over the past several decades the incidence and prevalence of cardiovascular risk factors has risen significantly, including the development of an epidemic of diabetes.Evidence suggests that these higher rates of cardiovascular risk factors, including tobacco abuse, diabetes, high blood pressure, and elevated cholesterol levels, may be placing an inordinate burden of cardiovascular disease on the American Indian and Alaska Native population. The rates of heart disease and stroke among American Indians and Alaska Natives are now higher than in the general U.S. population as well as in U.S. whites. Recent evaluations suggest that these rates are also higher than among other ethnic or racial populations in the United States. Additionally, American Indians and Alaska Natives have been found to have a substantially higher proportion of premature death from heart disease when compared with other ethnic and racial populations.A number of recent prevention initiatives and focused clinical efforts are making promising strides toward reduced disparities in cardiovascular health with primordial, primary, and secondary cardiovascular prevention efforts along with enhanced early identification and therapeutic intervention for more favorable cardiovascular outcomes in the future.In order to reach our goals of heart-healthy and stroke-free American Indians and Alaska Natives, implementation of an aggressive, reasonably resourced, systemic plan of coordinated health promotion, risk reduction, and disease control efforts are necessary, with appropriate policy and legislative support.