Risk factors, atherosclerosis, and cardiovascular disease among Aboriginalpeople in Canada: the Study of Health Assessment and Risk Evaluation in Aboriginal Peoples (SHARE-AP)

Background Little is known about the rates of cardiovascular disease (CVD), atherosclerosis, and their risk factors among Canada's Aboriginal people. To establish the relative prevalence of risk factors, atherosclerosis, and CVD, we undertook a population-based study among people of Aboriginal and E uropean ancestry in Canada. Methods We randomly recruited 301 Aboriginal people from the Six Nations Re servation, and 326 people of European origin from Hamilton, Toronto, and Ed monton, Canada. Clinical CVD was defined by history or electrocardiographic findings, atherosclerosis was measured by B-mode carotid ultrasonography, and conventional and new CVD risk factors were measured using standardised methods. Findings Aboriginal people had significantly more carotid atherosclerosis ( mean of the maximum intimal-medial thickness 0.82 (SD 0.20) mm vs 0.78 (0.2 0) mm, p = 0.027), and had a higher frequency of CVD (18.5% vs 7.6%, p = 0. 00002) compared with Europeans. Aboriginal people had significantly higher rates of smoking, glucose intolerance, obesity, abdominal obesity, and subs tantially higher concentrations of fibrinogen, and plasminogen activator in hibitor-1. Aboriginal people had significantly higher rates of unemployment and a lower annual household income. For any given income level, Aborigina l people had higher rates of risk factors and CVD compared with the Europea ns. Interpretation A significant proportion of Aboriginal people live in povert y which is associated with high rates of CVD and CVD risk factors. Improvem ent of the socioeconomic status of Aboriginal people might be a key to redu ce CVD in this group.