Abstract
Cardiovascular disease (CVD) is a major public health issue in indigenous populations
in the Arctic. These diseases have emerged concomitantly with profound social changes
over the past 60 years. The aim of this study was to summarize the literature on CVD
risk among Arctic Inuit. Literature on prevalence, incidence, and time trends for
CVD and its risk factors in Arctic Inuit populations was reviewed. Most evidence supports
a similar incidence of coronary heart disease and a higher incidence of cerebrovascular
disease among Arctic Inuit than seen in western populations. Factors that may increase
CVD risk include aging of the population, genetic susceptibility, and a rapid increase
in obesity, diabetes, and hypertension in parallel with decreasing physical activity
and deterioration of the lipid profile. In contrast, and of great importance, there
has been a decrease in smoking and alcohol intake (at least documented in Greenland),
and contaminant levels are declining. Although there have been marked socioeconomic
and dietary changes, it remains unsolved and to some extent controversial how this
may have influenced cardiovascular risk among Arctic Inuit. The increase in life expectancy,
in combination with improved prognosis for patients with manifest CVD, will inevitably
lead to a large increase in absolute numbers of individuals affected by CVD in Arctic
Inuit populations, exacerbated by the rise in most CVD risk factors over the past
decades. For preventive purposes and for health care planning, it is crucial to carefully
monitor disease incidence and trends in risk factors in these vulnerable Arctic populations.
Résumé
Les maladies cardiovasculaires (MCV) représentent un problème de santé publique majeur
dans les populations autochtones de l'Arctique. Ces maladies sont apparues de façon
concomitante avec de profonds changements sociaux au cours des 60 dernières années.
Le but de cette étude était de résumer les données de la littérature sur le risque
de maladies cardiovasculaires chez les Inuits de l'Arctique. La littérature sur la
prévalence, l'incidence et les tendances temporelles de MCV et de ses facteurs de
risque chez les populations inuites de l'Arctique a été examinée. La plupart des données
présentent une incidence similaire de la maladie coronarienne et une incidence plus
élevée de maladies cérébrovasculaires chez les Inuits de l'Arctique qu’observée dans
les populations occidentales. Les facteurs qui peuvent augmenter le risque de MCV
incluent le vieillissement de la population, une susceptibilité génétique, et une
augmentation rapide de l'obésité, du diabète et de l'hypertension, en parallèle avec
la diminution de l'activité physique et la détérioration du profil lipidique. En revanche,
et de façon importante, il y a eu une diminution du tabagisme et de la consommation
d'alcool (documentés au moins pour le Groenland), et les niveaux de contaminants sont
en déclin. Bien qu'il y ait eu des changements socio-économiques et alimentaires marqués,
la question de savoir comment cela peut avoir influencé le risque cardiovasculaire
chez les Inuits de l'Arctique demeure indéterminée et, dans une certaine mesure, controversée.
L'augmentation de l'espérance de vie, en combinaison avec une amélioration du pronostic
pour les patients atteints de MCV manifestes, conduira inévitablement à une forte
augmentation du nombre absolu de personnes touchées par les MCV chez les populations
inuites de l'Arctique, exacerbée par l’augmentation de la plupart des facteurs de
risque de MCV au cours des dernières décennies. À des fins de prévention et de planification
des soins de santé, il est indispensable de surveiller attentivement l'incidence de
ces maladies et les tendances des facteurs de risque dans ces populations vulnérables
de l'Arctique.
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Article info
Publication history
Published online: June 11, 2015
Accepted:
June 5,
2015
Received:
March 16,
2015
Footnotes
See page 1121 for disclosure information.
Identification
Copyright
© 2015 Canadian Cardiovascular Society. Published by Elsevier Inc. All rights reserved.
