Lee E T, Welty T K, Fabsitz R, Cowan L D, Le N A, Oopik A J, Cucchiara A J, Savage P J, Howard B V
Dept. of Biostatistics and Epidemiology, U. of Oklahoma Health Sciences Center, Oklahoma City 73190.
Am J Epidemiol. 1990 Dec;132(6):1141-55. doi: 10.1093/oxfordjournals.aje.a115757.
Available data indicate that cardiovascular disease has become the leading cause of death in American Indians. However, limited information is available on cardiovascular disease incidence, prevalence, and risk factors in this population. Reported cardiovascular disease rates vary greatly among groups in different geographic areas. These rates have been obtained from studies of varying sizes and different methodologies. The Strong Heart Study, which uses standardized methodology, is designed to estimate cardiovascular disease mortality and morbidity rates and the prevalence of known and suspected cardiovascular disease risk factors in American Indians. The study population consists of 12 tribes in three geographic areas: an area near Phoenix, Arizona, the southwestern area of Oklahoma, and the Aberdeen area of North and South Dakota. The study includes three components. The first is a mortality survey to estimate cardiovascular disease mortality rates for 1984-1988 among tribal members aged 35-74 years, and the second is a morbidity survey to estimate incidence of both first and first or recurrent hospitalized myocardial infarction and stroke (cerebrovascular disease) among tribal members aged 45-74 years in 1984-1988, and the third is a clinical examination of 4,500 tribal members aged 45-74 years in order to estimate the prevalence of cardiovascular disease and its associations with risk factors. Family history, diet, alcohol and tobacco consumption, physical activity, degree of acculturation, and socioeconomic status are assessed in personal interviews. The physical examination includes measurements of body fat, body circumferences, and blood pressure, an examination of the heart and lungs, an evaluation of peripheral vascular disease, and a 12-lead electrocardiogram. Laboratory measurements include fasting and postload glucose, insulin, fasting lipids, apoproteins, fibrinogen, and glycated hemoglobin. Also measured are serum and urine creatinine and urinary albumin. DNA from lymphocytes is isolated and stored for future genetic studies.
现有数据表明，心血管疾病已成为美国印第安人死亡的主要原因。然而，关于该人群心血管疾病的发病率、患病率和风险因素的信息有限。不同地理区域的群体报告的心血管疾病发病率差异很大。这些发病率来自规模和方法各异的研究。采用标准化方法的“强心研究”旨在估计美国印第安人心血管疾病的死亡率和发病率，以及已知和疑似心血管疾病风险因素的患病率。研究人群包括三个地理区域的12个部落：亚利桑那州凤凰城附近地区、俄克拉何马州西南部地区以及北达科他州和南达科他州的阿伯丁地区。该研究包括三个部分。第一部分是死亡率调查，以估计1984 - 1988年35 - 74岁部落成员的心血管疾病死亡率；第二部分是发病率调查，以估计1984 - 1988年45 - 74岁部落成员首次和首次或复发性住院心肌梗死及中风（脑血管疾病）的发病率；第三部分是对4500名45 - 74岁部落成员进行临床检查，以估计心血管疾病的患病率及其与风险因素的关联。通过个人访谈评估家族病史、饮食、烟酒消费、身体活动、文化适应程度和社会经济地位。体格检查包括测量体脂、身体周长和血压，检查心肺，评估外周血管疾病，以及进行12导联心电图检查。实验室测量包括空腹和负荷后血糖、胰岛素、空腹血脂、载脂蛋白、纤维蛋白原和糖化血红蛋白。还测量血清和尿肌酐以及尿白蛋白。从淋巴细胞中分离出DNA并储存起来以备将来进行基因研究。
