HYPERTENSION IN ADULT AMERICAN-INDIANS - THE STRONG HEART-STUDY

Hypertension is a primary risk factor for cardiovascular disease in th e United States. Although cardiovascular disease is the leading cause of death among American Indians, the prevalence of hypertension, its a wareness and control, and its association with other cardiovascular di sease risk factors and physiological variables have not been well stud ied in this population. The Strong Heart Study is a longitudinal study of cardiovascular disease and its risk factors in American Indians. P articipants (2703 women and 1846 men) were members of 13 tribes in cen tral Arizona, southwestern Oklahoma, and regions of South and North Da kota, At least 1500 individuals between 45 and 74 years of age partici pated from each center in a baseline clinical examination conducted be tween July 1989 and January 1992. The examination consisted of a perso nal interview and physical examination that included an oral glucose t olerance test and three consecutive blood pressure measurements. This study reports data from the baseline examination on the prevalence of hypertension and correlates of blood pressure. Results indicated that despite the high frequency of diabetes and obesity, prevalence rates o f hypertension in Arizona and Oklahoma were similar to those in the US population in the Third National Health and Nutrition Examination Sur vey (NHANES III), and rates among South/North Dakota participants were significantly lower (P < .0001). Blood pressure was higher in individ uals with diabetes (P < .0001) and was significantly correlated with a ge (P < .0001) and albuminuria (P < .0001) but only weakly related to obesity. There was no independent relation between blood pressure and insulin. Blood pressure seems to be less affected by obesity and hyper insulinemia in American Indians compared with other populations. Never theless, hypertension should be aggressively treated and controlled in American Indians because it is a known precursor to morbidity and mor tality associated with diabetes and cardiovascular disease.