Cardiovascular dynamics of Canadian Indigenous peoples

Abstract

Limited understanding of Indigenous adults’ cardiovascular structure and function exists despite high rates of cardiovascular disease. This investigation characterised cardiovascular structure and function among young Indigenous adults and compared to age- and sex-matched European descendants. Echocardiographic assessments included apical two- and four-chamber images, parasternal short-axis images and Doppler. Analyses included cardiac volumes, dimensions, velocities and strains. Cardiovascular structure and function were similar between Indigenous (n=10, 25 ± 3 years, 4 women) and European-descendant (n=10, 24 ± 4 years, 4 women,) adults, though European descendants demonstrated greater systemic vascular resistance (18.19 ± 3.94 mmHg∙min−1∙L−1 vs. 15.36 ± 2.97 mmHg∙min−1∙L−1, p=0.03). Among Indigenous adults, women demonstrated greater arterial elastance (0.80 ± 0.15 mmHg·mL−1·m−2 vs. 0.55 ± 0.17 mmHg·mL−1·m−2, p=0.02) and possibly greater systemic vascular resistance (17.51 ± 2.20 mmHg∙min−1∙L−1 vs. 13.93 ± 2.61 mmHg∙min−1∙L−1, p=0.07). Indigenous men had greater cardiac size, dimensions and output, though body size differences accounted for cardiac size differences. Similar cardiac rotation and strains were observed across sexes. Arterial elastance and cardiac size were different between Indigenous men and women while cardiovascular structure and function may be similar between Indigenous and European descendants.

The representation of Indigenous peoples in chronic disease clinical trials in Australia, Canada, New Zealand, and the United States

“…For instance, although cardiovascular disease disproportionately affects Indigenous peoples in Canada compared with the general population, 27 we were unable to identify Indigenous-specific clinical trials focused on this condition, rather there are more studies focused on other cardiometabolic conditions such as diabetes.…”

“… 26 In addition, it is worth noting that certain chronic conditions are mostly studied in some Indigenous populations, which may be due to community, researchers, or government interest. For instance, although cardiovascular disease disproportionately affects Indigenous peoples in Canada compared with the general population, 27 we were unable to identify Indigenous-specific clinical trials focused on this condition, rather there are more studies focused on other cardiometabolic conditions such as diabetes.…”

Modelling prevalent cardiovascular disease in an urban Indigenous population

“…It is commonly accepted that race and ethnicity are not biological, but they have tangible and meaningful impacts on Indigenous health outcomes (Watego et al, 2021). Evidence indicates that racialized differences in CVD are not due to genetics and physiology, meaning such inequities are due to other factors (Foulds et al, 2018). Despite evidence that traditional models of CVD risk perform worse for First Nations peoples than for the white or Black populations (D'Agostino et al, 2001), relatively little work has been done to identify risk factors specific to this population.…”

Anishinaabeg Elders’ Land-based Knowledge: Enacting Bagijigan for Health and Well-being

“…Anishinaabeg Elders' Land-based Knowledge: Enacting Bagijigan for Health and Well-being Indigenous health literature is expansive regarding the health disparities experienced between Indigenous and non-Indigenous peoples. In nearly all chronic health indicators, Indigenous peoples experience higher rates of ill health than non-Indigenous peoples in Canada (Foulds et al, 2018;Reading, 2015;Walker et al, 2020). For example, Indigenous peoples experience higher rates of Type 2 Diabetes and cardiovascular disease, as well as an overrepresentation of morbidity and mortality (Gracey & King, 2009).…”