Cardiovascular disease (CVD) and CVD risk factors among Montana American Indians with and without disability

The Montana Department of Public Health and Human Services in collaboration with the Billings Area Indian Health Service conducted a random digit dialing telephone survey among 1,000 adult American Indians in Montana in 2003. Respondents were asked questions regarding their history of CVD and CVD risk factors and two questions regarding their disability status.

Overall, one-fifth (22%) of respondents reported being disabled. Cardiovascular disease and CVD risk factors were prevalent among respondents: 11% reported a history of CVD, 16% diabetes, 34% high blood pressure, 22% high cholesterol, 36% were current smokers, and 38% were obese.

After adjusting for age and gender, respondents with disabilities were more likely to have CVD (odds ratio = 3.4), diabetes (2.1), and high blood pressure (2.3), and obesity (1.5) compared to respondents without disabilities. Respondents with disabilities were also more likely than their non-disabled peers to have high cholesterol (1.2) and be current smokers (1.2), but these factor differences were not significant once gender and age were statistically controlled.

The higher prevalence of disability among persons with CVD and CVD-related risk factors, unfortunately is not surprising, given the high prevalence of complications and functional limitations associated with diabetes (e.g., retinopathy, neuropathy, lower extremity amputations), stroke, and myocardial infarction. Continued public health and clinical efforts will be needed to reduce modifiable CVD risk factors (e.g., regular physical activity, healthy diet, smoking cessation) among those with and without disability. Concerted efforts to reach those with disabilities are warranted.