Background. Little is known about the causes and consequences of renal disease among American Indians in the Great Lakes region of the United States. Methods. We examined clinical correlates of albumin/creatinine ratios among 1368 participants in the three tribal communities of the Inter-Tribal Heart Project using univariate and multivariate analysis. Results. Compared to 1086 participants without albuminuria, the 240 with microalbuminuria (30 to 299 mg/g) and the 42 with macroalbuminuria (>300 mg/g) were more likely to report a history of a myocardial infarction (6.4%, 16.0%, and 23.8%, respectively, P < 0.001). Similarly, compared to patients without albuminuria, those with microalbuminuria and macroalbuminuria were more likely to report a history of stroke (2.3%, 8.4% and 26.2%, respectively, P < 0.001). In a multiple linear regression model, independent correlates of albumin excretion (P < 0.05) included: fasting blood sugar, treated diabetes, treated hypertension, higher systolic blood pressure, lower diastolic blood pressure, abnormal electrocardiogram, a history of stroke, the degree of American Indian heritage, and lower household income. Conclusions. Urinary albumin excretion is associated with cardiovascular disease outcomes and risk factors among American Indians of the Great Lakes region. Both heredity and socioeconomic status appear to play a role in the pathogenesis of renal injury in this population.
Bibliographical noteFunding Information:
This work was made possible by the people who agreed to participate in the Inter-Tribal Heart Project and the local tribal governments. This project was supported by a memorandum of understanding between the Centers for Disease Control and Prevention and the Indian Health Service. Special thanks to Ms. Jan Lovick for helping to prepare the manuscript.
- American Indian heritage
- Cardiovascular disease
- Great Lakes population
- Inter-Tribal Heart Project
- Myocardial infarction
- Socioeconomic status and health