http://www.tulsaworld.com/
by: KIM ARCHER
World Staff Writer
A researcher says the prevalence of diabetes in the population is tied to the problem.
American Indians have more strokes than white or black people in the U.S. and are more likely to die after their first stroke, a major national study led by a University of Oklahoma researcher shows.
It’s the largest epidemiologic study of cardiovascular disease in American Indians and the first to detail stroke incidence rates and risk factors for American Indians, said principal investigator Dr. Ying Zhang. Thirteen additional researchers from across the country were authors of the study, which was based at the OU College of Public Health.
The Strong Heart Study will be published next week in the American Heart Association’s journal, Circulation.
Researchers analyzed data from 4,549 middle-age and older subjects from 13 American Indian tribes in Oklahoma, Arizona, North Dakota and South Dakota. Only 42 participants had a history of stroke at their baseline exam.
During the 1989 to 2004 study period, 306 other subjects had their first stroke. According to researchers, the one-year fatality rate after the stroke was 32 percent among American Indian subjects, nearly 1 1/2 times more than rates found in white or black populations.
“The rate of first stroke was unusually high,” researchers wrote. “Stroke incidence exceeded that recorded in community-based studies of white and, notably, black U.S. populations, who have an especially high stroke rate.”
Zhang said the high prevalence of diabetes among American Indians is directly tied to the population’s stroke rate.
“Our findings confirm the strong associations between hypertension, diabetes and cigarette smoking and risk of stroke,” the study said.
Unlike white and black populations, in which men are at higher risk of stroke than women, gender was not a significant risk factor among American Indians, the study said.
However, American Indian men have a higher incidence of stroke than women.
And American Indian women are at higher risk of dying after their first stroke than men, the study said.
As with other populations, stroke was more prevalent among people ages 65 to 74 years, compared with those younger than 65. The mean age of occurrence of a first stroke was 66.5 years, the study said.
Zhang said she hopes that the data will be used to heighten stroke prevention among American Indians.
“To help prevent stroke, we need to target lowering blood pressure, controlling diabetes and stopping smoking,” she said.
American Indians represented in the study include Ak-Chin Tohono O’Odham (Papago)/Pima, Apache, Caddo, Cheyenne River Sioux, Comanche, Delaware, Spirit Lake, Fort Sill Apache, Gila River Pima Maricopa, Kiowa, Oglala Sioux, Salt River Pima/Maricopa, and Wichita Indian communities.
Strong Heart Study findings
* American Indians have more strokes than white or black people in the U.S.
* More American Indians die after their first stroke than white or black people.
* American Indian women are more likely to die after their first stroke than men.
* American Indian men have a higher incidence of stroke than women.
* Gender was not a significant risk factor among American Indians, unlike in white and black populations, where men are at higher risk.
* Stroke is more prevalent among American Indians older than 64; that’s similar to prevalence among white and black people.
Source: Strong Heart Study, Circulation, American Heart Association