Prevalence of Ischemic Heart Disease among American Indians and Alaska Natives with Diabetes, Indian Health Service, 2002
Abstract Number: 1009-P
Authors: NILKA RIOS BURROWS, MICHAEL M. ENGELGAU, KELLY J. ACTON
Institutions: Atlanta, GA; Albuquerque, NM
Results: Ischemic heart disease (IHD), which includes myocardial infarction, angina, and coronary heart disease, is a major cause of death among American Indians and Alaska Natives (AI/ANs). Since most studies on IHD have focused on mortality and little information is available on prevalence, we examined prevalence of IHD among AI/ANs with diabetes. From ambulatory care data of the Indian Health Service, we obtained the number of visits for IHD (ICD 410-414) during 2002 by patients with diabetes (ICD 250) in 23 states. We then calculated state-specific prevalence of IHD for AI/ANs aged 35 years or older using 2002 estimates of the AI/AN population with diabetes. Prevalence was age-adjusted based on the 2000 U.S. standard population. In 2002, in the 23 states studied, the age-adjusted prevalence of IHD among AI/ANs with diabetes ranged from 7.5% in Arizona to 18.8% in New York. In addition to Arizona and New York, the age-adjusted prevalence was low in Colorado (8.2%), Idaho (8.3%), and Nevada (8.3%), and high in South Dakota (16.5%) and Wyoming (18.4%). Overall, prevalence was greater among persons residing in Northern Plains states. Among AI/AN with diabetes aged 55 years or older, nearly one of five (19.0%) had a diagnosis of IHD, whereas the prevalence was lower among persons aged 35-54 years (5.6%). IHD imposes a major burden for the AI/AN population with diabetes. The differences in IHD prevalence by state may reflect differences in prevalence of smoking and other risk factors for cardiovascular disease. With the growing prevalence of diabetes in the AI/AN population, the number of persons with IHD in this population is likely to increase as well.