Heart disease and stroke affect all racial and ethnic groups in the U.S. Cardiovascular disease, including heart disease and stroke, is the leading cause of death for American Indians and Alaska Natives.

Coronary heart disease, the most common form of heart disease, affects the blood vessels (or coronary arteries) of the heart. It causes angina and heart attacks. Angina is a pain in the chest that happens when a part of the heart does not get enough blood. A heart attack can cause chest pressure, fullness, squeezing, or pain in the center of the chest that lasts longer than a few minutes, or comes and goes, spreading pain to one or both arms, back, jaw, or stomach, or cold sweats and nausea. Some women don't have these symptoms but may have other symptoms, such as an upset stomach, a burning feeling in the upper abdomen, and lightheadedness. A heart attack can cause permanent damage to the heart and maybe even death. If you have any of these symptoms, call 911 or see your health care provider right away.

There are two types of stroke. An ischemic (iss-kee-mik) stroke happens when a blood vessel that goes to the brain is blocked, and blood can't get to the brain. A hemorrhagic (heh-muh-ra-jik) stroke happens when a blood vessel breaks and blood goes into the brain. Sometimes a person can have a "mini stroke," or transient ischemic attack (TIA). A TIA is a stroke that happens when a blood vessel to the brain is blocked for a short time and less blood reaches the brain. A stroke could cause problems that may affect speech, language, movement, vision, balance, hearing, breathing, and swallowing. A stroke could also cause death. Diabetes, high blood pressure, high cholesterol, not exercising, and smoking all put women at risk for heart disease and stroke.

To avoid heart attack and stroke, the American Heart Association advises people to take the following steps:

* Don't smoke.
* Control your blood pressure. Ask your health care provider what a healthy number is for you and how often you need your blood pressure checked.
* Eat healthy.
* Lower your cholesterol (fatty substance in your blood) to the right level, based on your personal risk. Talk to your health care provider about a healthy level for you.
* Get at least 30 minutes of exercise on most days of the week.
* Maintain a healthy weight. Ask your health care provider what a healthy weight is for you.
* Have a normal fasting blood glucose level (below 110 mg/dL). Ask your health care provider when you should be tested.

Publications

1. For Your Heart - This portion of the NWHIC web site will escort you through a short, confidential survey of questions about your health and lifestyle. Based on your answers, it will provide you with a series of articles detailing the latest information on exercise, nutrition, smoking, diabetes, cholesterol, high blood pressure and other factors that affect you and your risk for heart disease - all tailored to your needs.

2. American Indian and Alaska Native People: Be active for your heart! - Heart disease is the leading cause of death for American Indians and Alaska Natives. This document offers insight about how to keep your heart healthy by staying active. It provides a listing of benefits from weight loss to strengthening your heart and lungs. Staying healthy can also be fun. Brisk walks, riding a bike, or even swimming are all great ways to keep your heart healthy regardless of your age.

3. American Indian and Alaska Native People: Treat Your Heart To A Healthy Celebration! - Proper nutrition is your way to a healthy heart. This document provides insight on eating the right kinds of foods to improve and maintain your health. It offers a list of foods, as well as ways for preparing them, to ensure healthy eating. Lean cut beefs, fish, corn, and rice are all tasty examples of a healthy diet.

4. American Indian and Alaska Native Women's Health - This site provides information to Indian Health Service providers and consumers about American Indian and Alaska Native women's health. It discusses access to care, violence against Native women, cancer, diabetes, HIV/AIDS, substance abuse, cardiovascular disease, and other health issues.

5. American Indian and Alaskan Native People: Help Your Heart! - Although the use of tobacco has been a part of the American Indian and Alaska Native culture for many years, health concerns associated with tobacco have been brought to the forefront. This document discusses the harmful effects of tobacco, such as heart attack, cancer, and lung problems. Its focus is to explain the dangers of tobacco use, while providing suggestions for staying healthy.

6. American Indian and Alaskan Native People: Keep the harmony within you - Check your blood pressure! - You could have high blood pressure and not even know it! Being aware of your blood pressure is key in preventing stroke, heart disease, kidney disease, and blindness. The information in this document shares tips on how to lower your blood pressure through diet and exercise.

7. Building Healthy Hearts for American Indians and Alaska Natives: Background Report - This background report provides an overview of cardiovascular disease and its associated risk factors among American Indians and Alaska Native populations in the United States. It also discusses the lessons learned from community-based projects and recommends strategies for effective education programs.

8. Facts About Heart Disease and Stroke Among American Indians and Alaska Natives - This publication contains facts and statistical information about the incidence of heart disease among American Indians and Alaska Natives.

9. Guide to Assessing Your Risks for Cardiovascular Disease and Stroke (Copyright © American Heart Association - This health risk awareness quiz focuses on heart attack and stroke and allows you to assess your risk for heart disease and stroke. Included is a stroke risk scorecard, and questions to ask your doctor.

10. Health and Heritage: Heart Disease and Stroke - This publication outlines the purpose and the goal of the Indian Health Service's (IHS) initiatives to reduce the burden of cardiovascular risk factors as well as prevent the development of CVD among American Indians and Alaska Natives.

11. High Blood Cholesterol - What You Need to Know - This brochure provides information about how to lower a cholesterol level that is too high. Lowering a cholesterol level that is too high helps to reduce the risk for heart disease. Find out what your cholesterol numbers mean and what treatment your doctor may prescribe to help lower your cholesterol level. Includes a tool to estimate the risk for having a heart attack, and outlines ways to reduce risk. Also contains a list of resources for further information.

12. Live Healthier, Live Longer: Cholesterol Counts for Everyone - Visit this interactive page to find information both for those who want to prevent heart disease and for those with heart disease who want to reduce their risk of having a heart attack. It contains a "how to" guide to lowering cholesterol, recipes, engaging activities such as Create-a-Diet, a resource library, tip sheets on heart healthy life habits, quizzes how to read food labels, frequently asked questions, and much more!

13. Statistical Fact Sheet: American Indians/Alaska Natives and Cardiovascular Diseases (Copyright © AHA) - This publication discusses factors behind high incidence of heart disease and stroke among American Indians and Alaska Natives.

Organizations

1. American Heart Association

2. CDC's WISEWOMAN™ - Well Integrated Screening and Evaluation for Women Across the Nation

3. Indian Health Services

4. National Heart, Lung, and Blood Institute, NIH, HHS

5. National Indian Women's Health Resource Center (NIWHRC)

6. WomenHeart - National Coalition for Women with Heart Disease