Congestive Heart FailureA population-based assessment of left ventricular systolic dysfunction in middle-aged and older adults: The Strong Heart Study☆,☆☆,★
Section snippets
Methods
The SHS is a population-based survey of cardiovascular risk factors and prevalent and incident cardiovascular disease in American Indians. As previously described,8, 9 members aged 45 to 74 years of 3 tribes in Arizona, 7 tribes in Oklahoma, and 3 tribes in North and South Dakota were recruited from tribal members living on reservations or (in Oklahoma) in a defined geographic area (overall participation rate 62%) for a first examination from 1989 to 1992.
The second SHS examination was
Characteristics of participants
Of 3501 participants who underwent echocardiography, 3184 (91%) had LVEF measurements needed for inclusion in the current study; excluded individuals were older (mean 60 vs 58 years) and heavier (body mass index 33.6 ± 8.6 vs 31.0 ± 6.2 kg/m2) and had worse lung function (forced expiratory volume in 1 second 73% vs 101% of predicted). Women comprised 2016 (63%) of participants; 1102 lived in Arizona, 1065 in Oklahoma, and 1017 in North and South Dakota; 1641 (52%) had diabetes and 1007 (33%)
Discussion
The current study represents the first comprehensive assessment of the prevalence and correlates of mild and severe systolic LVD in a large population-based sample of middle-aged and older American Indians. Our analyses reveal previously undocumented associations, independent of prevalent coronary heart disease or overt CHF, of systolic LVD with systemic arterial stiffening, renal dysfunction, and residence in North and South Dakota. Multivariate analyses confirmed expected associations between
Acknowledgements
We thank the Indian Health Service facilities, SHS participants, and participating tribal communities for extraordinary cooperation and involvement that made this study possible; Betty Jarvis, RN, Tauqeer Ali, MD, and Alan Crawford for study center coordination; Tauqeer Ali, MD, Helen Beaty, Joan Carter, Michael Cyl, and Neil Sikes for echocardiogram performance; and Virginia Burns for preparation of the manuscript.
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Cited by (0)
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Supported in part by grants No. U01-HL41642, U01-HL41652, U01-HL41654, and R01-HL55502 from the National Heart, Lung, and Blood Institute and by grant No. M10RR0047-34 (GCRC) from the National Institutes of Health, Bethesda, Md.
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This article does not represent the opinion of the Indian Health Service.
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Reprint requests: Richard B. Devereux, MD, Division of Cardiology, Box 222, New York Presbyterian Hospital, 525 E 68th St, New York, NY 10021. E-mail: [email protected]