native americans HEART DISEASE

metabolic risk factors

high prevalence of obesity - some studies estimate 50-52% obesity rate

high rates of hypertension, dyslipidemia and other cardiometabolic conditions

obesity →

chronic inflammation, excess adiposity linked to inflammation, dyslipdemia and oxidative stress all factors that damage endothelium and promote plaque formation

lifestyle and access compound risk

poor diet, physical inactivity, limited access to healthy foods, smoking and inadequate preventive care to contribute to accumulation of multiple risk factors

chronic inflammation and endothelial dysfunction

obesity and insulin resistance generate inflammatory cytokines and oxidative stress, this impairs endothelial nitric oxide productive (reduces vessel dilation and increases vascular stiffness)

hypertension and mechanical stress

high blood pressure adds mechanical stress to vessel walls, promoting remodeling smooth muscle hypertrophy, collagen deposition → stiffening, narrowing, increasing risk of arterial rupture

coronary artery disease

leads to chest pain, pressure, heaviness tigthness often with exertion

shortness of breath

fatigue, weakness

heart failure

dyspnea at rest on exertion

waking up night short of breath

possible arrhythmias (irregular heart beats, palpitations)

general symptoms

dizziness or lightheadedness

chronic fatigue, decreased exercise tolerance

chronic complications such as heart failure, kidney damage

targeted community based intervetions

culturally tailored lifestyle programs improved access to healthy foods and care, community health education

early screening and risk factor management

given early onset and high burden, start screening in younger age groups

more molecular and genetic research for native hawaiians

better understand whether there are unique factors in native hawaiian populations