Speaker Abstract

Diabetes and Cardiovascular Disease in Hispanic and Native Americans in the U. S.

Michael P. Stern, University of Texas Health Science Center, San Antonio, TX.

It is widely believed that Hispanic and native Americans, despite their high rates of diabetes, have paradoxically low rates of cardiovascular disease (CVD). Recent data, however, have called this concept into question. In the case of Hispanics, low CVD rates are based primarily on vital statistics which are subject to various biases, most of which tend to produce an underestimate of their CVD mortality. Recent coronary care unit surveillance data from Corpus Christi, TX and cohort data from San Antonio, TX suggest that CVD mortality in Hispanics is actually increased.

The belief that CVD rates in native Americans are low has been heavily influenced by data on Pima Indians, the most thoroughly studied native American population. Subsequent data from the Strong Heart Study indicated that native Americans from Oklahoma and North and South Dakota have higher CVD rates than Pima Indians. They also have more Caucasian admixture which could increase their CVD risk. With the advent of renal replacement therapy many diabetic native Americans who formerly succumbed to end stage diabetic renal disease now survive long enough to develop CVD. The most recent data suggest that CVD mortality in native Americans, including Pima Indians, is rising and now actually exceeds the rate in the general U. S. population.