Comanche Nation Hosts Strong Heart Study Seminar

Comanche Nation community members gathered at Watchetaker Hall on Wednesday, October 23, for a seminar on the Strong Heart Study. People aged 15 and older participated in the study, which began in 1988, with public involvement in 1989.

Dr. Tauqeer Ali is the principal investigator for the Oklahoma Strong Heart Study and a research professor in the Department of Biostatics and Epidemiology at the University of Oklahoma Health Sciences Center.

The Strong Heart Study is a cardiovascular research project examining risk factors in Native American populations. The first wave of enrollment included 4,500 participants from three centers: Arizona, Oklahoma and the Dakotas.

“In Oklahoma alone, we enrolled 1,500 participants, American Indian participants from the 12 tribal communities, and they had to be between the ages of 45 and 74 years of age at that time,” Ali said. “So, we enrolled those participants, and we invited them back to undergo a physical exam that included lab tests and a physical exam, including height and weight measurements to get their BMI and then their blood pressure measurements, and we did their EKG, those kind of things. And that was the baseline exam that was done. In addition to that, we administered different questionnaires, including medical history questionnaire, medication use, psychosocial questionnaires, questionnaires about their smoking or drinking habits. So, those were part of the baseline exam.”

Those participants would later come back every three to five years, and then 94 families were added after phase three, and another 3,600 people were added to the study.

Ali said there was a misconception that heart diseases are not high in Native American groups.

“Because American Indians used to be a very active group of people. They're hunters and physically very active group of people, so that may have given them the idea that heart diseases are not that high in this population,” he said. “However, on the contrary, when the Strong Heart Study did its research, we found out that the rates of coronary heart disease, which is the disease in which the blood vessels that supply blood to the heart muscles, they get blocked due to fat buildup. So, what we found that the rates of coronary heart disease was higher in American Indian population compared to other populations in the U.S., so that's what we found. We also found that because of the high rates of diabetes, we found that most of these cardiovascular diseases that occurred in individuals who had diabetes, and our study, Strong Heart Study, found that about 50 percent of our participants, original people, had diabetes.”

The study also found that LDL Cholesterol and blood pressure levels are generally lower in Native Americans than in other US populations. 

“Even at lower levels, they have to be monitoring, we have to be monitoring, you know, their heart health very closely,” Ali said. “It should not mislead you, ‘Oh, their level is low, so they might not have heart disease.’ That is not true for this population.”

He said heart disease is also found in younger age groups.

“We did echocardiograms, which are like ultrasound of your heart, and we found out that the abnormalities with the structure and function of the heart through this echocardiogram was apparent in adolescents at very young age, and most of those adolescents also had metabolic syndrome,” he said.

They found abnormalities in the heart's structure that were apparent in the younger age group.

“The key thing is to have that, you know, preventive approach, not wait until something has happened,” Ali said. “You have to  follow a healthy lifestyle, and starting at a very young age, and just doing healthy activities, physically being physically active, and eating healthy diet, and avoiding, you know, other risk factors of smoking and increase, you know, alcohol consumption, those kind of risk factors, avoiding that, avoiding, you know, trying to avoid stress, and those kind of things.”

He said the study also found a protein that could indicate damage to the kidney.  

“They demonstrated, they were found to be the most, the very powerful markers of future cardiovascular diseases, so we learned that as well, and also we found out that, you know, people who are physically inactive or consumed processed meat a lot, the chances or the probability of getting diabetes was higher in that group,” Ali said. “We found that depression was associated with a degree of glucose control in diabetics, meaning if they were, you know, getting their glucose under control, there's less likelihood of developing depression. We also do environmental studies as well in the strong heart study, and we found that arsenic and other metals, they contribute to the development of diabetes, heart diseases and renal issues.”

He said it’s important for the public to be educated on various subjects such as diet, physical activities, cancer, cardiovascular risk, liver issues, blood fat levels and children’s health.

“Death due to cardiovascular diseases is the leading cause of death, so it is very important for the American Indian community members to be mindful of their heart health, to be aware of their heart health, go for regular checkups, and make sure that they follow healthy behavior, like eating healthy diet, and then they exercise,” Ali said. “And do not get misled, as we talked about, like, you know, that even though the bad cholesterol level may be low compared to other U.S. populations, or even their blood pressure may be on the lower side compared to other U.S. populations, that should not mislead them to think that they are fine, you know…they should have their regular follow-up with their health care provider…not only for themselves but for their children also. It is important to keep all your health measures in optimal range.”

However, if someone does have heart disease, it can be controlled.

“Medical science has advanced that those diseases, most of them can be managed very easily,” he said. “…Again, you have to take care of yourself; you have to go for regular checkups, regular, to your health care provider.”

Strong Heart Study celebrated its 35th year in the 12 tribal communities.