Coronary heart disease and hypertension in the White Mountain Apache Tribe

DEATH from heart disease is much less common in American Indians than in U. S. citizens as a whole. The death rate in 1953 for all heart disease was 21/2 times as high for the general population as for the Indian. Arteriosclerotic heart disease caused three times as many deaths and hypertensive heart disease more than twice as many pro-portionately. ' Despite energetic efforts to ob-tain epidemiologic data on heart disease around the world, little work has been accom-plished in this field among American Indians. A few reports have appeared in which hos-pital records were reviewed.24 Some prelim-inary figures have appeared on the incidence of coronary artery disease as part of a com-prehensive health study of the Navajo.5 Plasma lipids and lipoproteins have been determined on a few Navajos.6''7 The fat con-tent of the Navajo diet has been a subject of controversy. Two of us (N.J.C. and T.F.L.) served as medical officers on the Fort Apache Indian Reservation at different times. Our experi-ence and that of other medical officers sta-tioned there by the U. S. Public Health Serv-ice has been that coronary artery disease is extremely rare in this Apache tribe. Over an 8-year period, dating from 1952, not a single Apache with angina pectoris or myocardial infaretion was treated in the Indian Hospital at Whiteriver, Arizona. During the same period, several Caucasians were treated for acute myocardial infaretion at the same hos-pital. Because of this apparent absence o