Chronic heart disease needs more study, experts agree

Page 9

Heart disease prevention programs aimed specifically at Native people seem scarce in British Columbia.

William Hamson-Fong, manager of cross-cultural programs for the Heart and Stroke Foundation of British Columbia and Yukon, said "the fact that we clearly have a higher incidence of heart disease among Aboriginals as a chronic disease means that it needs to be a priority."

But he isn't aware of studies done on Aboriginal people in the province as a separate group or of any grass-roots-level activities aimed to raise awareness, monitor heart problems or provide counselling. That may be because Hamson-Fong's organization in British Columbia has a mandate for fund-raising rather than implementing community heart health programs, but Raven's Eye contacted several First Nations and found that while some had diabetes programs, which encompass heart disease prevention too, none had specific heart health programs. The Heart and Stroke Foundation of Canada designates February as Heart Month.

The Assembly of First Nations has collaborated on some statistic-gathering about heart disease at a national level, excluding far northern communities, the James Bay region of Quebec and off-reserve populations. The result is heart disease at the top of the list of the AFN's chronic health risk survey results posted on the internet. The data from the First Nations and Inuit Regional Health Survey report says that eight per cent of First Nations and Inuit adults surveyed in 1997 reported heart problems. Worse still, heart disease rates for all ages in the surveyed Aboriginal communities are three times the Canadian average. Nationally, that's three times higher for Aboriginal men and 2.9 times higher for Aboriginal women.

Alarming as this is, up until the 1980s, statistics showed Aboriginal people had lower rates of heart disease than other Canadians. So, further surveys need to be done before drawing conclusions, the AFN's fact sheet says.

Hamson-Fong agreed.

"Aboriginal epidemiological information may not be available for British Columbia" apart from what is conducted in the population at large," he said.

But that does not mean people should ignore the risk factors that affect them now.

The big three contributing factors to ischemic heart disease are smoking, hypertension (high blood pressure) and high serum cholesterol.

The statistics reveal that a high number of the respondents had one or more of these risk factors.

First, smoking: The companion report on tobacco use resulting from the 1997 surveys reveals that 62 per cent of adult respondents smoked. As did nearly 75 per cent of respondents in their early twenties. In all, the Aboriginal rate of smokers, according to the surveys, was at least twice the Canadian average. Smoking constricts blood vessels, thus contributing to high blood pressure, the second big risk factor.

Aboriginal people also have much higher rates for hypertension than other Canadians, according to the national surveys, although earlier surveys indicated they had lower rates. The risk for hypertension in Aboriginal men and women is 2.8 and 2.5 times greater, respectively. Other than smoking, the kind and amount of diet and exercise usually affect people's risk for high blood pressure more than other factors. Obesity contributes to the risk of hypertension, and therefore the risk of heart attack, stroke, diabetes and other serious health problems.

Cholesterol rates, the third main risk factor, are affected by both diet and genetics. These rates have increased since the 1970s too, the national surveys reveal. Formerly, Aboriginal people were found to be at lower risk than average to develop high cholesterol.

Another factor that contributes to the risk of getting heart disease is diabetes, which is acknowledged by experts as being of epidemic proportions in many communities, at three to five times the rate as for non-Aboriginal Canadians. Diabetes is associated with a great number of health problems, including hig blood pressure and circulatory problems, which lead to heart disease and stroke.

Hamson-Fong agrees with medical experts who point out that Aboriginal communities that currently seem to be targeting diabetes as their number one health problem can expect to see a reduction in heart disease, too, as a result of their efforts.

"By addressing the risk factors for heart disease and stroke," Hamson-Fong said, "it has quite universal health benefits."

Prevention measures consist of stopping smoking if you smoke, reducing cholesterol by choosing a healthy diet, exercising and maintaining a normal weight. Getting your blood pressure checked periodically is important too, especially if it has been a problem or you have other risk factors.

Sheila Thiessen, a community outreach nurse with the Central Interior Native Health Society in Prince George, said last year in February they held a heart health workshop that attracted 160 people, but they don't have the resources to do the same thing this year.

(See Heart on page 10.)

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Thiessen echoed Hamson-Fong's remarks linking heart disease and diabetes.

"As Type II diabetes is on the rise and impacting heart health," she said, "blood sugar clinics are offered in conjunction with blood pressure clinics every Tuesday morning . . . at the Native Health Society."

She adds no appointments are necessary. During the clinics, a nurse assesses and talks over the clients' diet, activity, cigarette smoking and stress levels with them and makes referrals to doctors when needed.

Jackie Albany, administrator for the Songhees First Nation just outside Victoria, said they conducted a pilot project for diabetes last year and learned that 11 of 385 people there have it. She says they have seen a substantial rise in diabetes in the last five years, and she provided statistics that again link that with heart disease and stroke. Her community, however, plans a follow-up project this year that will focus strongly on nutrition an diet. They're also trying to get a part-time nurse to help identify and treat problems sooner and the community is looking at implementing healthy lunch programs for the youth.

The fact sheet posted by the AFN says ischemic heart disease rates can be lowered by introducing screening programs to detect, monitor and treat high blood pressure.