ArticlesRisk factors, atherosclerosis, and cardiovascular disease among Aboriginal people in Canada: the Study of Health Assessment and Risk Evaluation in Aboriginal Peoples (SHARE-AP)
Introduction
Although in the past 50 years the rates of deaths from acute infectious diseases has declined among Aboriginal people in Canada, their life expectancy remains much lower compared with others living in Canada.1, 2 Furthermore, although the prevalence of cardiovascular disease (CVD) has been declining in Canada, there are data to suggest that CVD rates are increasing among Aboriginal people.3 Therefore, establishing the prevalence of risk factors for atherosclerosis and CVD among Aboriginal people is important to address an impending epidemic of CVD in this group.
The Aboriginal people who participated in this study come from the Six Nations Reserve in Brant County, Ontario, Canada which is located 30 km from Hamilton, Ontario, Canada. The Six Nations Reserve took its present form of 20 000 hectares in 1847, and is home to 10 000 Aboriginal people. In a health survey by the Six Nations Health Committee in 1997, heart disease and diabetes were reported as the most frequent health disorders affecting people living on the reserve. The Study of Health Assessment and Risk Evaluation in Aboriginal Peoples (SHARE-AP) was designed to investigate the burden of atherosclerosis, CVD, and their determinants among the Six Nations people, and was a joint initiative between the Six Nations people and investigators from the neighboring McMaster University.
Section snippets
Methods
Study population
We randomly selected participants from a comprehensive list of Six Nations Band members. Their addresses and phone numbers were identified by searching local telephone directories. From this list, households were randomly selected and mailed an introductory letter, followed by up to 12 telephone calls inviting the individual with the earliest date of birth in the household to participate in the study. Individuals between 35 and 75 years who were Six Nations Band Members, who had
Results
Of 379 eligible Aboriginal people, 79% of individuals completed the health assessment between October, 1998, and May, 2000, at the Gane Yohs Community Health Centre located on the Six Nations Reserve. Of 450 eligible European-Canadian people, 326 (72%) completed the health assessment between April, 1997, and October, 1998, as previously described.14 The exact details of the recruitment of these two groups are provided in figure 1. Aboriginal people were more often deemed ineligible for
Discussion
We have shown that Aboriginal people in Canada have a higher frequency of CVD and have a greater burden of atherosclerosis compared with Canadians of European ancestry. The rates of conventional risk factors, including glucose abnormalities, abnormal lipids, hypertension, tobacco use, obesity, as well as some novel risk factors associated with the development of thrombosis, are also significantly increased among the Aboriginal people. Although these are likely to be the immediate determinants
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