Cardiovascular Health among U.S. Indigenous Peoples: A Holistic and Sex-Specific Systematic Review

ABSTRACT

Purpose: The purpose of this systematic review is to examine mental, sociocultural, behavioral, and physical risk and protective factors related to cardiovascular disease (CVD) and related outcomes among U.S. Indigenous peoples.

Methods: A total of 51 articles met the inclusion criteria of research focusing factors for CVD among U.S. Indigenous peoples (Mental n = 15; Sociocultural, n = 17; Behavioral/Physical, n = 19).

Results: This review reveals clear risks for CVD, which tended to be elevated for females. Mental health problems (depression, anxiety, PTSD/trauma, alcohol, and other drug (AOD) abuse) were clearly associated with CVD, along with enculturation, social support, and the social environment – including discrimination and trauma. Poor diet and obesity, diabetes, hypertension, cholesterol were behavioral or physical factors.

Discussion: Overall, identified research was limited and in beginning stages, lacking more information on etiology of the interconnections across sex and the mental, sociocultural, and behavioral determinants of CVD.

KEYWORDS:

• Native American or American Indian or Alaska Native or Native Hawaiian
• cardiovascular disease
• mental health
• cultural factors
• social factors
• diabetes

Additional information

Funding

This work was supported by the Fahs-Beck Fund for Research and Experimentation Faculty Grant Program [grant number #552745]; The Silberman Fund Faculty Grant Program [grant #552781]; the Newcomb College Institute Faculty Grant at Tulane University, University Senate Committee on Research Grant Program at Tulane University, the Global South Research Grant through the New Orleans Center for the Gulf South at Tulane University, The Center for Public Service at Tulane University, and the Carol Lavin Bernick Research Grant at Tulane University. This work was supported, in part, by Award K12HD043451 from the Eunice Kennedy Shriver National Institute of Child Health & Human Development of the National Institutes of Health (Krousel-Wood-PI; Catherine Burnette-Building Interdisciplinary Research Careers in Women’s Health (BIRCWH) Scholar). Supported in part by U54 GM104940 from the National Institute of General Medical Sciences of the National Institutes of Health, which funds the Louisiana Clinical and Translational Science Center. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health;National Institute of General Medical Sciences [U54 GM104940];Eunice Kennedy Shriver National Institute of Child Health and Human Development [K12HD043451].